A 40-year-old male who crashed his motorcycle had a brief loss of consciousness, woke up, and walked home. You find him two hours later unconscious. What should you suspect?

Get ready for the Paramedic Readiness Exam 5. Study with multiple-choice questions, detailed explanations, and effective strategies. Enhance your exam preparedness today!

Multiple Choice

A 40-year-old male who crashed his motorcycle had a brief loss of consciousness, woke up, and walked home. You find him two hours later unconscious. What should you suspect?

Subdural hematoma fits this scenario because the pattern is a head injury with a brief loss of consciousness, a period of apparent recovery, and then a delayed, progressive deterioration. This happens when bridging veins are torn and blood accumulates slowly between the dura and the arachnoid. The slower buildup allows the patient to seem fine for a while before increasing intracranial pressure causes unconsciousness, which can occur hours after the injury. In contrast, an epidural hematoma is typically due to arterial bleeding and tends to progress more rapidly after a lucid interval, often with more conspicuous focal signs and a quicker decline. A concussion would not produce a mass effect or a delayed collapse, and “traumatic brain injury” is a broad umbrella term that doesn’t point to the specific delayed bleed described here. In practice, this patient requires emergent imaging and neurosurgical evaluation to assess and evacuate a potentially life-threatening hematoma.

Subdural hematoma fits this scenario because the pattern is a head injury with a brief loss of consciousness, a period of apparent recovery, and then a delayed, progressive deterioration. This happens when bridging veins are torn and blood accumulates slowly between the dura and the arachnoid. The slower buildup allows the patient to seem fine for a while before increasing intracranial pressure causes unconsciousness, which can occur hours after the injury.

In contrast, an epidural hematoma is typically due to arterial bleeding and tends to progress more rapidly after a lucid interval, often with more conspicuous focal signs and a quicker decline. A concussion would not produce a mass effect or a delayed collapse, and “traumatic brain injury” is a broad umbrella term that doesn’t point to the specific delayed bleed described here.

In practice, this patient requires emergent imaging and neurosurgical evaluation to assess and evacuate a potentially life-threatening hematoma.

More practice questions