Neuroimaging: tension pneumocephalus: 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: tension pneumocephalus

Sample item

Two days after a frontal skull base fracture, a man deteriorates. CT shows bifrontal air collections that compress and separate the frontal lobes into two pointed peaks over the midline. What is this sign called?

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

The answer and the reasoning

D. Mount Fuji sign

In tension pneumocephalus air under pressure separates and compresses the frontal lobes, whose tips look like twin peaks and give the Mount Fuji sign. It needs urgent decompression. The hummingbird sign is midbrain atrophy in PSP, the swallow tail sign relates to nigrosome-1, and the dense MCA sign signals thrombus.

Option by option

  • A. Hummingbird sign

    The hummingbird sign is a midbrain atrophy pattern in progressive supranuclear palsy.

  • B. Dense MCA sign

    The dense MCA sign is a hyperdense vessel from acute thrombus.

  • C. Swallow tail sign

    The swallow tail sign refers to the normal nigrosome-1 appearance on susceptibility MRI.

  • D. Mount Fuji sign (correct)

    Correct. The Mount Fuji sign marks tension pneumocephalus.

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 D, Mount Fuji sign. In tension pneumocephalus air under pressure separates and compresses the frontal lobes, whose tips look like twin peaks and give the Mount Fuji sign.

Why is "Hummingbird sign" not the answer?

The hummingbird sign is a midbrain atrophy pattern in progressive supranuclear palsy.

Why is "Dense MCA sign" not the answer?

The dense MCA sign is a hyperdense vessel from acute thrombus.

Why is "Swallow tail sign" not the answer?

The swallow tail sign refers to the normal nigrosome-1 appearance on susceptibility MRI.

What concept does this question test?

It tests Neuroimaging: tension pneumocephalus in Radiology. It needs urgent decompression. The hummingbird sign is midbrain atrophy in PSP, the swallow tail sign relates to nigrosome-1, and the dense MCA sign signals thrombus.

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: tension pneumocephalus?

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.