Differential Diagnosis for a 57-year-old Female who Fell and Hit her Head
Single most likely diagnosis
- Concussion: This is the most likely diagnosis given the mechanism of injury (falling and hitting her head) and the presence of nausea, which is a common symptom following a concussion.
Other Likely diagnoses
- Cervical strain: The fall could have also caused a strain to the neck muscles, leading to pain and stiffness.
- Laceration or scalp hematoma: Direct trauma to the head could result in a laceration or hematoma, especially if the fall was onto a hard surface.
- Whiplash-associated disorder: Although more commonly associated with car accidents, a fall could potentially cause a whiplash-type injury, especially if the head was snapped back upon impact.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epidural hematoma: A potentially life-threatening condition where bleeding occurs between the skull and the dura mater, which could be caused by the fall. Symptoms might not be immediately apparent but could rapidly deteriorate.
- Subdural hematoma: Similar to an epidural hematoma but the bleeding occurs beneath the dura mater. It's a medical emergency that requires immediate attention.
- Subarachnoid hemorrhage: Bleeding into the space surrounding the brain, which could be caused by trauma. It's a serious condition that requires prompt medical intervention.
- Cervical spine fracture: A fracture in the neck could lead to spinal cord injury, which is a medical emergency.
Rare diagnoses
- Vertebral artery dissection: A tear in the vertebral artery, which could be caused by trauma to the neck. It's a rare but potentially serious condition that could lead to a stroke.
- Carotid artery dissection: Similar to vertebral artery dissection but involves the carotid artery. It's rare and could lead to a stroke.
- Basilar skull fracture: A fracture at the base of the skull, which could be caused by significant trauma to the head. It's a serious condition that might not always be immediately apparent.