Differential Diagnosis for 11-year-old Baseball Player
- Single most likely diagnosis
- Concussion: The patient's initial symptoms of disorientation, muffled hearing, headache, and unsteadiness after being hit on the head with a baseball are consistent with a concussion. The fact that he has improved significantly over the past 2 hours also fits with this diagnosis, as concussions often have a transient course.
- Other Likely diagnoses
- Scalp laceration or contusion: Although the patient was wearing a helmet, it's possible that the impact caused a laceration or contusion to the scalp, which could explain the initial headache and tight sensation.
- Post-traumatic headache: The patient's description of a tight sensation in his head, which he now describes as eyestrain, could be a post-traumatic headache, which is a common sequela of head injury.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epidural hematoma: Although the patient's symptoms have improved, it's essential to consider the possibility of an epidural hematoma, which can present with a lucid interval followed by rapid deterioration.
- Subdural hematoma: Similar to an epidural hematoma, a subdural hematoma can be a devastating consequence of head trauma, and its presentation can be subtle, especially in the early stages.
- Skull fracture: A skull fracture could be present, even with a helmet, and could lead to further complications such as cerebrospinal fluid leak or infection.
- Rare diagnoses
- Concussive syndrome: This is a rare condition characterized by persistent symptoms after a concussion, which can include headaches, dizziness, and cognitive difficulties.
- Post-concussive syndrome: Similar to concussive syndrome, post-concussive syndrome is a rare condition that can occur after a concussion, characterized by persistent symptoms such as headaches, fatigue, and irritability.