Differential Diagnosis

The patient's symptoms of intermittent headaches, dizziness, and problems with memory and word-finding difficulty after a fall are concerning and warrant a thorough evaluation. The following differential diagnoses are considered:

• Single most likely diagnosis
  • Post-Concussive Syndrome: This is the most likely diagnosis given the patient's history of a fall and subsequent symptoms of headaches, dizziness, and cognitive difficulties. The fact that the CT Head was unremarkable does not rule out this diagnosis, as post-concussive syndrome is a clinical diagnosis.
• Other Likely diagnoses
  • Cervicogenic Headache: The patient's fall and landing on her elbow could have caused a cervical spine injury, leading to cervicogenic headaches and dizziness.
  • Vertebral Artery Dissection: Although less likely, the patient's fall could have caused a vertebral artery dissection, which could lead to headaches, dizziness, and cognitive difficulties.
  • Subdural Hematoma: Although the CT Head was unremarkable, a subdural hematoma could still be present, especially if it is small or chronic.
• Do Not Miss diagnoses
  • Subarachnoid Hemorrhage: This is a potentially life-threatening condition that could be caused by a traumatic aneurysm or arteriovenous malformation. Although the CT Head was unremarkable, a lumbar puncture or further imaging may be necessary to rule out this diagnosis.
  • Carotid Artery Dissection: This is another potentially life-threatening condition that could be caused by the patient's fall. A carotid artery dissection could lead to stroke or other neurological deficits.
  • Epidural Hematoma: Although less likely, an epidural hematoma could still be present, especially if the patient has a skull fracture or other underlying condition.
• Rare diagnoses
  • Chronic Subdural Hematoma: This is a rare condition that could be caused by a traumatic brain injury. Although the CT Head was unremarkable, a chronic subdural hematoma could still be present.
  • Traumatic Aneurysm: This is a rare condition that could be caused by the patient's fall. A traumatic aneurysm could lead to subarachnoid hemorrhage or other neurological deficits.
  • Dural Arteriovenous Fistula: This is a rare condition that could be caused by the patient's fall. A dural arteriovenous fistula could lead to headaches, dizziness, and cognitive difficulties.