Differential Diagnosis for Small Brain Contusion
- Single most likely diagnosis
- Traumatic Brain Injury (TBI): This is the most likely diagnosis given the presentation of a small brain contusion, as it is a direct result of trauma to the head, which can cause bruising of the brain tissue.
- Other Likely diagnoses
- Cerebral Vasculitis: Inflammation of the blood vessels in the brain could potentially cause small areas of bruising or contusion, although this would typically be accompanied by other symptoms such as fever, headache, and neurological deficits.
- Hypertensive Encephalopathy: Severe high blood pressure can lead to small brain hemorrhages or contusions, especially if there's a sudden spike in blood pressure.
- Arteriovenous Malformation (AVM): AVMs are abnormal connections between arteries and veins, which can rupture and cause small contusions or hemorrhages.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aneurysmal Rupture: Although less likely, a ruptured aneurysm can present with a small contusion and is a medical emergency requiring immediate intervention.
- Hemorrhagic Transformation of Ischemic Stroke: In some cases, an ischemic stroke can transform into a hemorrhagic stroke, presenting with small contusions, which is critical to identify for appropriate management.
- Infectious Causes (e.g., Brain Abscess): Certain infections can cause focal brain lesions that might resemble a contusion, and missing these could lead to severe consequences.
- Rare diagnoses
- Cerebral Amyloid Angiopathy: A condition characterized by the deposition of amyloid proteins in the blood vessels of the brain, which can lead to small hemorrhages or contusions, more commonly seen in the elderly.
- Moyamoya Disease: A rare condition caused by narrowing or blockage of the internal carotid artery and its branches, which can lead to small brain contusions due to decreased blood flow.
- Coagulopathy: Disorders of blood clotting can increase the risk of spontaneous bleeding in the brain, presenting as small contusions, and are important to consider, especially in patients with a history of bleeding disorders.