Differential Diagnosis
- Single most likely diagnosis
- C) Intracranial hypertension: This diagnosis is the most likely due to the patient's symptoms of bilateral disc edema, daily mild to moderate headaches that are present upon awakening and improve throughout the day, intermittent tinnitus, and occasional greying out of vision when bending over. These symptoms are classic for idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri.
- Other Likely diagnoses
- E) Tension-type headache: Although less likely than intracranial hypertension, tension-type headaches can present with similar symptoms such as mild to moderate, bilateral, and pressing headaches. However, the presence of disc edema and visual symptoms makes this diagnosis less likely.
- D) Migraine: Migraines can cause a variety of symptoms including headaches, tinnitus, and visual disturbances. However, migraines typically have a more episodic nature and are often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- A) Carbon monoxide poisoning: Although unlikely, carbon monoxide poisoning can cause headaches, tinnitus, and visual disturbances. It is essential to consider this diagnosis, especially if there are any potential sources of carbon monoxide exposure.
- Brain tumor or other space-occupying lesion: Although not listed as an option, it is crucial to consider the possibility of a brain tumor or other space-occupying lesion, which could cause increased intracranial pressure and similar symptoms.
- Rare diagnoses
- B) Cluster headache: Cluster headaches are rare and typically present with severe, unilateral pain, often accompanied by autonomic symptoms such as nasal congestion and lacrimation. The patient's symptoms do not align well with cluster headaches.
- Other rare causes of increased intracranial pressure: Such as cerebral venous sinus thrombosis, meningitis, or encephalitis, which could present with similar symptoms but are less likely given the patient's history and examination findings.