Differential Diagnosis after a Fall and Hitting the Head
Single Most Likely Diagnosis
- Concussion: This is the most common diagnosis after a fall and hitting the head, especially if the patient experienced a loss of consciousness, confusion, or amnesia. Concussions are a type of mild traumatic brain injury (mTBI) caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull.
Other Likely Diagnoses
- Laceration or Contusion: Direct trauma to the head can result in lacerations (cuts) or contusions (bruises) of the scalp, which are common and often require stitches or observation.
- Skull Fracture: A fracture of the skull can occur from a significant impact to the head. Symptoms may include pain, swelling, bruising, and in severe cases, neurological deficits.
- Subdural Hematoma: This condition involves bleeding into the space between the brain and the skull, often due to a tear in the blood vessels. It can be acute or chronic and may present with headache, confusion, or loss of consciousness.
Do Not Miss Diagnoses
- Epidural Hematoma: A life-threatening condition where there is bleeding between the skull and the dura (the outermost membrane covering the brain). It often requires immediate surgical intervention and can present with a loss of consciousness, severe headache, or neurological deficits.
- Subarachnoid Hemorrhage: Bleeding into the space surrounding the brain (the subarachnoid space) can be due to trauma or an aneurysm rupture. Symptoms include sudden severe headache, vomiting, and possible loss of consciousness.
- Cervical Spine Injury: Injuries to the neck, including fractures or dislocations, can occur during a fall and are critical to identify to prevent further injury during movement or transport.
Rare Diagnoses
- Traumatic Arteriovenous Fistula: An abnormal connection between arteries and veins that can occur after trauma, potentially leading to neurological symptoms or hemorrhage.
- Pneumocephalus: The presence of air or gas within the cranial cavity, which can occur after a skull fracture that communicates with the external environment or sinuses.
- Cerebral Vasospasm: A condition where the blood vessels in the brain constrict, potentially leading to ischemia. It is more commonly associated with subarachnoid hemorrhage but can be considered in the differential diagnosis of post-traumatic neurological deterioration.