What is the likely cause of a 33-year-old male patient's sudden loss of vision, accompanied by a diaphoretic episode, with a past medical history (PMHx) of migraines and a traumatic brain injury (TBI) 14 years ago from a motor vehicle accident (MVA), who experiences relief with ibuprofen and Excedrin (acetaminophen, aspirin, and caffeine)?

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Differential Diagnosis for 33 yo Male Patient with Sudden Loss of Vision and Diaphoretic Episode

  • Single most likely diagnosis
    • Migraine with aura: The patient's history of migraines, description of pressure in both temporal sides, and vision turning gray are consistent with a migraine aura. The episode of sudden loss of vision and diaphoretic episode could be a variant of migraine with aura.
  • Other Likely diagnoses
    • Ocular migraine: This condition is characterized by transient visual symptoms, including loss of vision, and is often accompanied by headache and other migraine symptoms.
    • Tension headache: The patient's description of pressure in both temporal sides could be indicative of a tension headache, which may have triggered the episode of loss of vision.
    • Dehydration: Although the patient reports being well-hydrated, dehydration can cause visual disturbances and diaphoretic episodes, especially in individuals who are physically active.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Stroke or transient ischemic attack (TIA): Although the patient is young, a stroke or TIA can occur at any age, and sudden loss of vision is a red flag symptom that requires immediate attention.
    • Subarachnoid hemorrhage: This is a life-threatening condition that can cause sudden headache, visual disturbances, and diaphoretic episodes.
    • Pituitary apoplexy: This is a rare but potentially life-threatening condition that can cause sudden headache, visual disturbances, and other symptoms.
  • Rare diagnoses
    • Multiple sclerosis: This condition can cause visual disturbances, including loss of vision, and may be accompanied by other neurological symptoms.
    • Optic neuritis: This is an inflammatory condition that can cause sudden loss of vision and may be accompanied by pain and other symptoms.
    • Arteriovenous malformation (AVM): This is a rare condition that can cause visual disturbances, including loss of vision, and may be accompanied by other neurological symptoms.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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