Differential Diagnosis for Head Injury
Single Most Likely Diagnosis
- Scalp Hematoma or Laceration: Given the weight and distance of the falling object, a direct impact to the head is likely to cause a scalp hematoma or laceration, resulting in swelling at the site of impact.
Other Likely Diagnoses
- Concussion: A head injury from a 15-pound object falling 4 feet can cause a concussion, even if there is no visible injury, due to the force of the impact on the brain.
- Subgaleal Hematoma: The force of the impact can also cause bleeding into the subgaleal space, leading to a subgaleal hematoma, which may present with swelling and possibly other neurological symptoms.
- Linear Skull Fracture: Although less common, a linear skull fracture is possible, especially if the object's edge struck the head, causing a fracture line without significant displacement.
Do Not Miss Diagnoses
- Epidural Hematoma: Although less likely, an epidural hematoma is a potentially life-threatening condition that requires immediate attention. It can occur if the impact causes a tear in the meningeal arteries, leading to rapid bleeding between the skull and the dura mater.
- Subdural Hematoma: Similar to an epidural hematoma, a subdural hematoma is a serious condition where blood accumulates between the dura mater and the arachnoid membrane, potentially causing increased intracranial pressure and brain damage.
- Depressed Skull Fracture: A depressed skull fracture, where fragments of the skull are pushed into the brain, is another critical condition that must not be missed, as it can cause significant brain injury and requires surgical intervention.
Rare Diagnoses
- Penetrating Skull Injury: Depending on the shape and material of the 15-pound object, there is a small chance it could penetrate the skull, causing a penetrating brain injury, which is rare but extremely serious.
- Cerebral Contusion: While more common in higher-impact injuries, cerebral contusion (bruising of the brain tissue) could occur, especially if the force of the impact was concentrated on a small area of the head.