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Epidural haematoma — MCCQE Part 1 MCQ

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ModerateTraumaEpidural haematomaMCCQE Part 1

A 19-year-old man is struck on the temple, briefly loses consciousness, then becomes alert. Two hours later he develops worsening headache, vomiting and unilateral dilated pupil. Which of the following is the most likely diagnosis?

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Correct answer: D — Epidural haematoma

A temporal impact with lucid interval followed by deterioration and ipsilateral pupil dilation is classic epidural haematoma from middle meningeal arterial bleeding. Concussion should not cause progressive focal signs. This is a neurosurgical emergency requiring urgent CT and decompression pathway.

Reference: Canadian CT Head Rule; Canadian neurosurgical trauma practice