A 24-year-old man is struck on the right temporal region during a cricket match. He is initially conscious but progressively loses consciousness over the next 2 hours. On examination, his right pupil is dilated and non-reactive. What is the most likely source of bleeding?

• A Bridging veins
• B Dural venous sinuses
• C Cortical arteries
• D Middle meningeal artery ✓

Explanation

The classic presentation of epidural hematoma includes a lucid interval followed by neurological deterioration and ipsilateral pupillary dilation from uncal herniation. The middle meningeal artery is torn, typically by a fracture of the squamous temporal bone. Bridging veins are the source of subdural hematoma, which usually lacks a lucid interval and presents more insidiously.

Reference: Schmidek and Sweet's Operative Neurosurgical Techniques, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.