Injuries and wounds: delayed traumatic apoplexy: practice question

A Forensic Medicine 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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Forensic Medicine · Injuries and wounds: delayed traumatic apoplexy

Sample item

A normotensive man collapses with a massive intracerebral haemorrhage 10 days after a minor blow to the head. Angiography and autopsy show no aneurysm or vascular malformation. This delayed event is known as:

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

The answer and the reasoning

A. Bollinger's traumatic apoplexy

Delayed traumatic intracerebral haemorrhage, described by Bollinger, appears days to weeks after a seemingly trivial head injury in a person with no vascular disease. Duret haemorrhages are brainstem bleeds from downward herniation, and berry aneurysm and hypertensive bleeds have a vascular cause that is absent here.

Option by option

  • A. Bollinger's traumatic apoplexy (correct)

    Correct. Late massive bleeding after minor head trauma without vascular disease is Bollinger's apoplexy.

  • B. Duret haemorrhage

    Duret haemorrhage is a brainstem lesion due to raised pressure and herniation.

  • C. Hypertensive Charcot-Bouchard bleed

    A Charcot-Bouchard bleed needs chronic hypertension, which this man did not have.

  • D. Berry aneurysm rupture

    A berry aneurysm is excluded by the investigation findings.

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 Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Bollinger's traumatic apoplexy. Delayed traumatic intracerebral haemorrhage, described by Bollinger, appears days to weeks after a seemingly trivial head injury in a person with no vascular disease.

Why is "Duret haemorrhage" not the answer?

Duret haemorrhage is a brainstem lesion due to raised pressure and herniation.

Why is "Hypertensive Charcot-Bouchard bleed" not the answer?

A Charcot-Bouchard bleed needs chronic hypertension, which this man did not have.

Why is "Berry aneurysm rupture" not the answer?

A berry aneurysm is excluded by the investigation findings.

What concept does this question test?

It tests Injuries and wounds: delayed traumatic apoplexy in Forensic Medicine. Duret haemorrhages are brainstem bleeds from downward herniation, and berry aneurysm and hypertensive bleeds have a vascular cause that is absent here.

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 Injuries and wounds: delayed traumatic apoplexy?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.