Differential Diagnosis for Head Injury at Work
Single Most Likely Diagnosis
- Concussion or Mild Traumatic Brain Injury (mTBI): The patient reports a headache after a head injury at work without loss of consciousness, nausea, vomiting, double vision, or blurred vision, which are common symptoms of a concussion. The absence of severe symptoms suggests a mild injury.
Other Likely Diagnoses
- Cervicogenic Headache: The headache could be referred from the cervical spine, especially if the injury involved a whiplash-type mechanism or if the patient has a pre-existing cervical spine condition.
- Tension Headache: Stress and muscle tension from the injury or the work environment could contribute to a tension headache.
- Post-Traumatic Headache: This is a broad category that encompasses various headache types following a head injury, including migraines, cluster headaches, or other primary headache disorders triggered by the trauma.
Do Not Miss Diagnoses
- Epidural Hematoma or Subdural Hematoma: Although the patient denies loss of consciousness, nausea, and vomiting, these symptoms can sometimes be delayed or absent in cases of intracranial bleeding. Missing these diagnoses could be fatal.
- Skull Fracture: A fracture could be present even without severe symptoms, especially if it's a non-displaced fracture. This could lead to complications like meningitis or further injury if not addressed.
- Intracranial Hemorrhage: Similar to epidural or subdural hematomas, other forms of intracranial bleeding (e.g., subarachnoid hemorrhage, intraparenchymal hemorrhage) are critical to identify promptly.
Rare Diagnoses
- Arteriovenous Fistula or Malformation: Trauma can rarely cause the formation of an arteriovenous fistula or malformation, leading to headache and potentially more severe neurological symptoms.
- CSF Leak: A head injury could result in a cerebrospinal fluid leak, which might present with headache, among other symptoms like clear nasal discharge.
- Traumatic Meningitis: Although rare, head trauma can introduce bacteria into the cranial vault, leading to meningitis, which would present with severe headache, fever, and stiff neck.