Differential Diagnosis for SDH Emergency
Single most likely diagnosis
- Subdural Hematoma (SDH): This is the most likely diagnosis given the context of the question, as SDH is a serious medical condition that requires emergency attention. It is characterized by bleeding into the space between the brain and the skull, often due to head trauma.
Other Likely diagnoses
- Epidural Hematoma: Similar to SDH, epidural hematoma is a type of bleeding in the brain, but it occurs between the skull and the dura mater, a membrane that surrounds the brain. It is also often caused by head trauma and can present with similar symptoms.
- Intracerebral Hemorrhage: This refers to bleeding within the brain tissue itself and can be caused by various factors, including hypertension, trauma, or vascular malformations. Symptoms can overlap with those of SDH, making it a plausible differential diagnosis.
- Subarachnoid Hemorrhage: Bleeding into the space surrounding the brain (the subarachnoid space) can be due to aneurysm rupture, trauma, or other causes. While the presentation might differ, the emergency nature of the condition warrants its consideration.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Brain Tumor with Hemorrhage: Although less common, a brain tumor that bleeds can mimic the symptoms of an acute SDH. Missing this diagnosis could lead to delayed treatment of the underlying tumor.
- Arteriovenous Malformation (AVM) with Hemorrhage: An AVM is a tangle of blood vessels in the brain that can rupture, leading to bleeding. Identifying and treating an AVM is crucial to prevent further hemorrhages.
- Infectious Causes (e.g., Abscess): In rare cases, symptoms mimicking an SDH could be due to an infectious process like a brain abscess. Antibiotic treatment would be necessary, making this a critical diagnosis not to miss.
Rare diagnoses
- Cerebral Venous Sinus Thrombosis: This condition involves a blood clot in the venous sinuses of the brain and can present with a variety of symptoms, including those that might suggest an SDH. It is less common but requires specific treatment.
- Hemorrhagic Transformation of an Ischemic Stroke: In some cases, an ischemic stroke can undergo hemorrhagic transformation, leading to bleeding within the brain. This would typically occur in the context of a known stroke but could be considered in the differential diagnosis of an emergency with suspected intracranial hemorrhage.