Differential Diagnosis for Head Injury
The patient's presentation of nausea, confusion, and worsening headache after a head injury suggests a traumatic brain injury. The following differential diagnoses are considered:
- Single most likely diagnosis
- Epidural hematoma: This is a likely diagnosis given the patient's loss of consciousness followed by a lucid interval and subsequent deterioration. Epidural hematomas are often associated with a temporal bone fracture and middle meningeal artery injury, which can occur with head-to-ground contact.
- Other Likely diagnoses
- Subdural hematoma: This is another possible diagnosis, as subdural hematomas can occur with head trauma and present with similar symptoms.
- Intraparenchymal hemorrhage: This is a possible diagnosis, as intraparenchymal hemorrhage can occur with head trauma and present with worsening headache and confusion.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although less likely, subarachnoid hemorrhage is a potentially life-threatening condition that requires prompt diagnosis and treatment.
- Cerebral edema: This is a potentially life-threatening condition that can occur with head trauma and requires prompt diagnosis and treatment.
- Rare diagnoses
- Diffuse axonal injury: This is a rare but potentially severe diagnosis that can occur with head trauma and present with prolonged loss of consciousness and cognitive impairment.
- Arteriovenous malformation (AVM) rupture: This is a rare diagnosis, but it is possible that the head trauma could have ruptured a pre-existing AVM, leading to hemorrhage.
A noncontrast CT scan of the head is essential to evaluate the patient's condition and guide further management. The CT scan can help identify the presence of hemorrhage, edema, or other injuries that require prompt attention.