Arab Board Neurosurgery Final Clinical & Oral Practice Questions - Arab Board Of Health Specializations (ABHS) Neurosurgery Final Clinical And Oral Examination Exam

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A 24-year-old male is brought to the emergency department after a motor vehicle crash. He had an initial brief loss of consciousness, followed by a 2-hour lucid interval. On arrival, his GCS drops from 14 to 7, and he develops an ipsilateral dilated, fixed right pupil and contralateral left hemiparesis. Urgent non-contrast head CT demonstrates a biconvex, hyperdense extra-axial collection in the right temporoparietal region. What is the most likely injured vascular structure and definitive management?

Bridging cortical veins; emergent decompressive hemicraniectomy with duraplasty Middle meningeal artery; emergent right pterional or temporal craniotomy with hematoma evacuation Superior sagittal sinus; conservative management with intracranial pressure monitoring Internal carotid artery laceration; emergent balloon occlusion and endovascular stenting

Correct Answer:

Middle meningeal artery; emergent right pterional or temporal craniotomy with hematoma evacuation

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