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Epidural haematoma — MCCQE Part 1 MCQ

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HardTraumaEpidural haematomaMCCQE Part 1

A 21-year-old man is struck on the temple, briefly loses consciousness, then has a lucid interval followed by worsening headache and reduced consciousness. Which of the following is the most appropriate next step?

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Correct answer: A — Urgent CT head and neurosurgical consultation

Urgent CT head and neurosurgical consultation is the single best answer because the age, timing, examination findings and investigations in the vignette fit Epidural haematoma better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian neurosurgical trauma guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian neurosurgical trauma guidance