Differential Diagnosis for Patient on Plavix with Head Trauma and Neurological Symptoms

Single Most Likely Diagnosis

• Subdural Hematoma: Given the patient's use of Plavix (clopidogrel), an antiplatelet medication, and the recent history of a fall with head trauma, a subdural hematoma is highly plausible. The symptoms of stiff neck and headache further support this diagnosis, as they can indicate increased intracranial pressure or irritation of the meninges.

Other Likely Diagnoses

• Epidural Hematoma: Although less likely than subdural hematoma due to the patient's age and the mechanism of injury, an epidural hematoma is still a possibility, especially if the patient experienced a significant impact to the head.
• Cervical Strain or Fracture: The fall could have resulted in a cervical spine injury, which might cause neck stiffness and headache. The use of Plavix increases the risk of bleeding, which could complicate a cervical fracture.
• Concussion: A concussion is a common consequence of head trauma and could explain the headache. However, the presence of a stiff neck might suggest a more severe injury.

Do Not Miss Diagnoses

• Subarachnoid Hemorrhage: Although less common, a subarachnoid hemorrhage is a potentially life-threatening condition that could be caused by the trauma, especially in the context of anticoagulation therapy. The symptoms of headache and stiff neck are consistent with this diagnosis.
• Spinal Epidural Hematoma: This is a rare but potentially devastating condition that could result from the trauma and anticoagulation, leading to spinal cord compression.
• Cervical Vertebral Artery Dissection: Trauma can cause dissection of the vertebral arteries, which could lead to stroke or other neurological complications. The use of Plavix might increase the risk of bleeding associated with this condition.

Rare Diagnoses

• Traumatic Arteriovenous Fistula: A rare complication of head trauma, which could lead to various neurological symptoms depending on the location and size of the fistula.
• Cerebral Venous Sinus Thrombosis: Although rare, the combination of trauma and anticoagulation therapy might predispose to this condition, which could present with headache and other neurological symptoms.