Differential Diagnosis
The provided findings suggest a normal brain CT scan with no evidence of acute or chronic pathology. Based on the information, the following differential diagnoses can be considered:
- Single most likely diagnosis
- Normal variant or non-specific headache: The lack of any focal findings, intracranial hemorrhage, mass, infarct, or mass effect suggests that the patient's symptoms may not be related to a structural brain abnormality.
- Other Likely diagnoses
- Migraine or tension headache: These conditions are common and may not have a visible correlate on CT scans.
- Sinusitis: The presence of retention cysts/mucosal polyps in the sphenoid sinus could be related to sinusitis, which can cause headaches.
- Vasculitis or reversible cerebral vasoconstriction syndrome: Although less likely, these conditions can cause headaches and may not be visible on a single CT scan.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage (SAH) with minimal blood: Although the CT scan does not show any evidence of hemorrhage, a small SAH can be missed, especially if the scan is done early after the event.
- Cerebral venous sinus thrombosis: This condition can cause headaches and may not be visible on a non-contrast CT scan.
- Pituitary apoplexy: A sudden hemorrhage or infarction in the pituitary gland can cause severe headaches and may not be visible on a CT scan without contrast.
- Rare diagnoses
- Chiari malformation: A congenital condition that can cause headaches, although it is less likely given the lack of any visible abnormalities on the CT scan.
- Idiopathic intracranial hypertension: A condition characterized by increased intracranial pressure without a visible cause, which can cause headaches and may not be visible on a CT scan.