Differential Diagnosis for a Bump to the Crown of the Head
Single Most Likely Diagnosis
- Concussion: This is the most likely diagnosis given the delayed onset of headache with exertion after a bump to the head. Concussions are common in athletes and can present with a variety of symptoms, including headache, which may worsen with physical activity. The fact that symptoms developed 24 hours after the injury is consistent with a concussion, as symptoms can be delayed.
Other Likely Diagnoses
- Cephalohematoma or Subgaleal Hematoma: These are collections of blood that can occur after a head injury, leading to a painful bruised head. They can cause headache and may be distinguished from a concussion by the presence of a palpable mass or swelling on the head.
- Linear Skull Fracture: A skull fracture can cause headache and may be associated with a bruise or swelling at the site of impact. However, it is less likely than a concussion given the absence of immediate symptoms or other signs of severe head injury.
Do Not Miss Diagnoses
- Epidural or Subdural Hematoma: Although less likely, these are potentially life-threatening conditions that require immediate medical attention. They can present with delayed onset of symptoms, including headache, after a head injury. A high index of suspicion is necessary, especially if the patient's condition worsens or if there are other concerning signs such as vomiting, confusion, or seizures.
- Subarachnoid Hemorrhage: This is another serious condition that can occur after head trauma, characterized by bleeding into the space surrounding the brain. It can present with sudden onset of severe headache, but in some cases, the onset may be delayed.
Rare Diagnoses
- Arteriovenous Fistula or Pseudoaneurysm: These vascular injuries can occur after penetrating or severe head trauma and are less likely in this scenario. However, they can cause headache and other neurological symptoms due to abnormal blood flow.
- Osteomyelitis or Abscess of the Scalp: Infection of the bone or soft tissues of the scalp can cause a painful, swollen area on the head, but this would be an unusual complication of a minor head injury and is more likely to occur in the context of a penetrating wound or compromised immune system.