Differential Diagnosis for 20-month-old Fall from Bed
- Single most likely diagnosis
- Minor head trauma or scalp hematoma: This is the most likely diagnosis given the age of the child and the mechanism of injury. A fall from a bed can result in a bump or bruise to the head, which is common in toddlers who are learning to navigate their environment.
- Other Likely diagnoses
- Skull fracture: Although less common, a skull fracture is a possible diagnosis, especially if the child fell onto a hard surface or from a significant height.
- Concussion or mild traumatic brain injury: A fall from a bed can also result in a concussion or mild traumatic brain injury, especially if the child hit their head on the floor or another object.
- Soft tissue injury (e.g., bruise, laceration): The child may also have sustained a soft tissue injury, such as a bruise or laceration, as a result of the fall.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epidural hematoma or subdural hematoma: Although rare, these conditions can be life-threatening if not promptly diagnosed and treated. A fall from a bed can cause bleeding in the brain, which can lead to increased intracranial pressure and potentially fatal outcomes.
- Spinal cord injury: Although unlikely, a spinal cord injury is a possibility, especially if the child fell onto their neck or back.
- Abusive head trauma (shaken baby syndrome): It is essential to consider the possibility of abusive head trauma, especially if the child's injury is inconsistent with the reported mechanism of injury or if there are other signs of abuse.
- Rare diagnoses
- Basilar skull fracture: This is a rare but potentially serious diagnosis that can occur if the child fell onto their head or neck.
- Cervical spine fracture or dislocation: Although rare, a cervical spine fracture or dislocation is a possible diagnosis, especially if the child fell onto their neck or back.
- Intracranial hemorrhage (e.g., subarachnoid hemorrhage): This is a rare but potentially life-threatening diagnosis that can occur if the child sustained a significant head injury.