Differential Diagnosis for Head Injury
After slipping on the ice and hitting the head, several conditions could be considered based on the symptoms described. Here's a categorized differential diagnosis:
Single most likely diagnosis
- Concussion: This is the most likely diagnosis given the mechanism of injury (slipping on ice and hitting the head) and the symptoms of headache and nausea without reported loss of consciousness. Concussions are common after such incidents and can present with these symptoms.
Other Likely diagnoses
- Post-traumatic headache: This could be a direct result of the head injury and might not necessarily imply a more severe condition like a concussion. The headache could be due to muscle tension, stress, or minor injury to the scalp or neck.
- Cervical strain or whiplash: Even if the primary concern is the head, the mechanism of injury could also have caused strain to the neck muscles, leading to headache and nausea.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epidural hematoma or subdural hematoma: Although less likely if there was no loss of consciousness, these conditions can present with a lucid interval followed by rapid deterioration. They are medical emergencies requiring immediate intervention.
- Skull fracture: A fracture could be present even without severe symptoms initially, and it's crucial to rule this out, especially if the headache worsens or if there are signs of trauma to the skull.
- Intracranial hemorrhage: Similar to hematomas, any form of bleeding inside the skull is a medical emergency and could initially present with headache and nausea.
Rare diagnoses
- Meningitis: Although rare in this context, if the skull was fractured and the meninges were compromised, there's a small risk of meningitis, especially if the patient starts showing signs of infection or severe headache with fever.
- Post-concussive syndrome: This is more of a long-term condition but could be considered if symptoms persist beyond the expected recovery time for a concussion. It involves a variety of symptoms including headache, dizziness, and cognitive difficulties.