Differential Diagnosis for 18 y/o Involved in a Rear-End Collision
Single Most Likely Diagnosis
- Whiplash Injury: This is the most likely diagnosis given the mechanism of injury (rear-end collision) and the patient's report of hitting his head but not losing consciousness. Whiplash injuries are common in such accidents and can cause neck pain, stiffness, and headaches.
Other Likely Diagnoses
- Cervical Strain: Similar to whiplash, a cervical strain is a possible diagnosis due to the sudden movement and force exerted on the neck during the collision.
- Concussion: Although the patient denies losing consciousness, a concussion is still possible, especially if the impact was significant enough to cause the patient's head to hit something inside the vehicle.
- Soft Tissue Injury: The collision could have resulted in soft tissue injuries, including bruises or muscle strains, in various parts of the body, depending on how the patient was positioned and restrained during the impact.
Do Not Miss Diagnoses
- Spinal Cord Injury: Although less likely, a spinal cord injury is a critical diagnosis that must not be missed. Even if the patient is ambulatory and denies significant symptoms, some spinal cord injuries can present subtly or worsen over time.
- Intracranial Hemorrhage: The patient's denial of losing consciousness does not entirely rule out the possibility of an intracranial hemorrhage, which could be life-threatening if not promptly diagnosed and treated.
- Fractures: Fractures of the cervical spine, thoracic spine, or other parts of the body could occur from the collision and must be considered, especially if the patient reports severe pain or has deformities.
Rare Diagnoses
- Diffuse Axonal Injury: This is a type of brain injury caused by shearing forces that occur when the brain rapidly accelerates or decelerates, typically seen in high-speed collisions or severe impacts.
- Vascular Injuries: Injuries to the carotid or vertebral arteries, such as dissections or thromboses, are rare but potentially life-threatening complications of neck trauma.
- Seatbelt Syndrome: This refers to a constellation of injuries, including abdominal and spinal injuries, caused by the seatbelt in high-impact collisions.