Question

bobby was in a coma after his high-speed car accident. his neurosurgeon was concerned that due to the accident he had sustained:

concussion and contusion
concussion and hematoma
contusion and subdural hematoma
stroke

Explanation:

Analyze the clinical scenario

Using the Comatose Definition knowledge point
Bobby is in a coma following a high-speed motor vehicle accident. A coma is a state of profound unconsciousness caused by severe disruption to the brain's reticular activating system or bilateral cerebral hemispheres.

Evaluate neurological injuries

Using the Neurological Disorders knowledge point
A high-speed impact commonly causes severe traumatic brain injuries. While a concussion is a mild, transient injury, a prolonged coma indicates more significant structural damage, such as a cerebral contusion (bruising of brain tissue) and a subdural hematoma (bleeding between the dura mater and arachnoid mater), which exerts pressure on the brainstem.

Compare the options

• "concussion and contusion": A concussion alone does not typically result in a prolonged coma.
• "Concussion and hematoma": Concussion is too mild to explain a deep comatose state.
• "contusion and subdural hematoma": Both represent severe structural injuries (bruising and major intracranial bleeding) that directly cause increased intracranial pressure and coma.
• "stroke": A stroke is typically a cerebrovascular event rather than a direct result of acute mechanical trauma.

Answer:

• (A) concussion and contusion
• (B) Concussion and hematoma
• (C) contusion and subdural hematoma (Correct answer)
• (D) stroke