Case History: A 62 year old female patient presented with severe headaches and disorientation, neck pain and thoracic spine pain two days after a Motor Vehicle Collision.

The patient states that she was sober and seat-belted, driving a Prius and traveling through an intersection at about 35 mph when she was T-Boned on the left side of her vehicle by a truck traveling 40 mph that went through a red light. The truck sheared off the front end of the Prius which spun. The air bag of the Prius engaged but it did not strike the patient. The patient went to the emergency room and was discharged with a diagnosis of cervical sprain.

This patient states that her head pain is constant and she is having difficulty thinking and remembering, especially words. She is very fatigued and cannot concentrate. Her neck pain is described as sharp without radiations into her upper extremity. Her thoracic spine pain is described the same way. This patient does not smoke nor is she on any medications. She walks daily but has not been up to exercise since the crash. She is a lawyer in private practice and cannot focus or have energy to work at this time.

Question: Based on this clinical history, what are some of the differential diagnoses you are considering?