Systemic pathology: hypertensive intracerebral haemorrhage: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: hypertensive intracerebral haemorrhage

Sample item

A 62-year-old hypertensive man collapses with sudden right hemiplegia. CT shows a haemorrhage in the left putamen. Which vascular lesion is responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Charcot-Bouchard microaneurysm

Chronic hypertension produces lipohyalinosis and Charcot-Bouchard microaneurysms in small penetrating arteries such as the lenticulostriate branches, which rupture into the putamen, thalamus, pons and cerebellum. Cerebral amyloid angiopathy causes lobar haemorrhage in the elderly.

Option by option

  • A. Saccular aneurysm at the circle of Willis

    Saccular aneurysm rupture causes subarachnoid haemorrhage.

  • B. Charcot-Bouchard microaneurysm (correct)

    Correct. Hypertensive microaneurysms rupture in the basal ganglia.

  • C. Cerebral amyloid angiopathy

    Amyloid angiopathy causes lobar cortical haemorrhage in normotensive elderly patients.

  • D. Arteriovenous malformation

    An arteriovenous malformation causes haemorrhage in younger patients and is not associated with hypertension.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Charcot-Bouchard microaneurysm. Chronic hypertension produces lipohyalinosis and Charcot-Bouchard microaneurysms in small penetrating arteries such as the lenticulostriate branches, which rupture into the putamen, thalamus, pons and cerebellum.

Why is "Saccular aneurysm at the circle of Willis" not the answer?

Saccular aneurysm rupture causes subarachnoid haemorrhage.

Why is "Cerebral amyloid angiopathy" not the answer?

Amyloid angiopathy causes lobar cortical haemorrhage in normotensive elderly patients.

Why is "Arteriovenous malformation" not the answer?

An arteriovenous malformation causes haemorrhage in younger patients and is not associated with hypertension.

What concept does this question test?

It tests Systemic pathology: hypertensive intracerebral haemorrhage in Pathology. Cerebral amyloid angiopathy causes lobar haemorrhage in the elderly.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: hypertensive intracerebral haemorrhage?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.