Differential Diagnosis for Bleeding from Ear after a Fall
- Single most likely diagnosis
- Basilar skull fracture: This is the most likely diagnosis because falls can cause significant trauma to the head, leading to fractures of the base of the skull, which can result in bleeding from the ear due to the proximity of the fracture to the ear canal and middle ear structures.
- Other Likely diagnoses
- Laceration of the external ear: A fall can cause direct trauma to the external ear, resulting in lacerations that bleed.
- Middle ear injury: The middle ear can be injured during a fall, leading to bleeding from the ear.
- Otitis externa or media with perforation: Pre-existing infections of the outer or middle ear can become perforated due to the trauma of a fall, leading to bleeding.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cerebrospinal fluid (CSF) leak: A basilar skull fracture can lead to a leak of CSF through the ear, which can be life-threatening due to the risk of meningitis.
- Vascular injury (e.g., carotid artery or jugular vein injury): Although less common, significant trauma to the neck or head during a fall can injure major blood vessels, leading to potentially life-threatening bleeding.
- Rare diagnoses
- Temporal bone fracture: While fractures of the temporal bone can occur, they are less common than basilar skull fractures and can still cause bleeding from the ear.
- Arteriovenous malformation (AVM) or other vascular anomalies: Pre-existing vascular anomalies could potentially bleed after minor trauma, including a fall, though this would be rare and typically associated with other symptoms or a known history of such conditions.