Differential Diagnosis for Concussion

When considering a diagnosis of concussion, it's crucial to evaluate a range of potential causes for the presenting symptoms. The following differential diagnosis is organized into categories to help guide the diagnostic process:

• Single Most Likely Diagnosis

  • Concussion: This is the most likely diagnosis given the context of the question. A concussion, also known as a mild traumatic brain injury (mTBI), is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. The symptoms can include headache, dizziness, confusion, nausea, and difficulty with concentration and memory.

• Other Likely Diagnoses

  • Post-concussive syndrome: This condition occurs in some people after a concussion and can involve a variety of symptoms such as headaches, dizziness, and cognitive difficulties that last for weeks or even months after the initial injury.
  • Skull fracture: A fracture to the skull can present with similar symptoms to a concussion but may also include more severe signs such as bleeding from the ears or nose, bruising behind the ears, or a depressed area of the skull.
  • Cervical spine injury: Injuries to the neck can cause similar symptoms to a concussion, including pain, stiffness, and neurological deficits.

• Do Not Miss Diagnoses

  • Epidural hematoma: A potentially life-threatening condition where bleeding occurs between the skull and the dura (the outermost membrane covering the brain), which can lead to increased intracranial pressure and brain herniation if not promptly treated.
  • Subdural hematoma: Similar to an epidural hematoma but the bleeding occurs between the dura and the arachnoid membrane (the middle layer covering the brain), also potentially life-threatening.
  • Subarachnoid hemorrhage: Bleeding into the space between the brain and the tissue that covers it (the subarachnoid space), which can be due to trauma or other causes like aneurysm rupture.

• Rare Diagnoses

  • Second impact syndrome: A rare but potentially fatal condition that occurs when an individual suffers a second concussion before the symptoms of the first have fully resolved, leading to severe and potentially fatal brain swelling.
  • Arteriovenous malformation (AVM) rupture: Although rare, an AVM rupture can mimic the symptoms of a concussion but is due to the rupture of an abnormal connection between arteries and veins in the brain.
  • Encephalitis or meningitis: Infections of the brain or the membranes surrounding the brain and spinal cord, respectively, which can present with symptoms overlapping those of a concussion but are due to an infectious cause.