Differential Diagnosis for Head Trauma with GCS of 15, Scalp Lacerations, and Bleeding from Ear

• Single Most Likely Diagnosis
  • Basilar Skull Fracture: This is the most likely diagnosis given the presence of bleeding from the ear, which is a common sign of a basilar skull fracture. The patient's GCS of 15 suggests that they are currently alert and able to follow commands, but the presence of a scalp laceration and ear bleeding indicates the need for further evaluation.
• Other Likely Diagnoses
  • Concussion: Despite a normal GCS, the patient may still have suffered a concussion, which can present with a variety of symptoms including headache, dizziness, and confusion. The presence of a scalp laceration supports the possibility of a concussion.
  • Epidural Hematoma: Although less likely given the patient's GCS of 15, an epidural hematoma is a possible diagnosis, especially if the patient has a history of loss of consciousness or worsening symptoms over time.
• Do Not Miss Diagnoses
  • Subarachnoid Hemorrhage: This is a potentially life-threatening condition that requires prompt diagnosis and treatment. Even with a GCS of 15, a subarachnoid hemorrhage can occur and may not always present with immediate symptoms.
  • Subdural Hematoma: Similar to an epidural hematoma, a subdural hematoma is a serious condition that can present with a variety of symptoms, including headache, confusion, and loss of consciousness.
  • Cerebral Vasospasm: This is a potentially life-threatening complication of subarachnoid hemorrhage and requires prompt diagnosis and treatment.
• Rare Diagnoses
  • Arteriovenous Malformation (AVM): Although rare, an AVM can present with bleeding and should be considered in the differential diagnosis, especially if the patient has a history of similar episodes or if imaging studies suggest the presence of an AVM.
  • Meningioma: This is a rare diagnosis, but a meningioma can present with bleeding and should be considered if imaging studies suggest the presence of a tumor.