Neuroimaging: subdural empyema: practice question

A Radiology 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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Radiology · Neuroimaging: subdural empyema

Sample item

A teenager with sinusitis develops fever, headache and focal seizures. MRI shows a crescentic extra-axial collection over the convexity with marked diffusion restriction and rim enhancement. What is the diagnosis?

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

The answer and the reasoning

B. Subdural empyema

Pus in the subdural space gives a crescentic collection that restricts diffusion and enhances at the margins. Sinusitis is a common source, and it needs urgent drainage and antibiotics. A hygroma follows CSF signal, a chronic haematoma lacks restricted diffusion, and an epidural abscess is lens-shaped and limited by sutures.

Option by option

  • A. Subdural hygroma

    A hygroma is CSF signal and does not restrict diffusion.

  • B. Subdural empyema (correct)

    Correct. A crescentic collection with diffusion restriction is subdural pus.

  • C. Epidural abscess

    An epidural abscess is lens-shaped and does not cross sutures.

  • D. Chronic subdural haematoma

    A chronic subdural haematoma does not restrict diffusion strongly and has no rim enhancement with fever.

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 Radiology question

What is the answer to this Radiology question?

The best answer is B, Subdural empyema. Pus in the subdural space gives a crescentic collection that restricts diffusion and enhances at the margins.

Why is "Subdural hygroma" not the answer?

A hygroma is CSF signal and does not restrict diffusion.

Why is "Epidural abscess" not the answer?

An epidural abscess is lens-shaped and does not cross sutures.

Why is "Chronic subdural haematoma" not the answer?

A chronic subdural haematoma does not restrict diffusion strongly and has no rim enhancement with fever.

What concept does this question test?

It tests Neuroimaging: subdural empyema in Radiology. Sinusitis is a common source, and it needs urgent drainage and antibiotics. A hygroma follows CSF signal, a chronic haematoma lacks restricted diffusion, and an epidural abscess is lens-shaped and limited by sutures.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Neuroimaging: subdural empyema?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.