Differential Diagnosis for Right Sided Hearing Loss and Headache

• Single Most Likely Diagnosis

  • b. Acoustic neuroma: This is a benign tumor growing on the cranial nerve running from the brain to the inner ear, which can cause hearing loss, often in one ear, and is accompanied by other symptoms such as headache due to the tumor's pressure on surrounding structures.

• Other Likely Diagnoses

  • a. Ménière’s disease: A disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. While it typically affects both ears, it can start in one ear, and the hearing loss can be progressive.
  • d. Sensorineural hearing loss: This can result from various causes, including exposure to loud noise, certain medications, and age. It could be unilateral and might be accompanied by headache if the cause is related to increased intracranial pressure or other systemic conditions.

• Do Not Miss Diagnoses

  • These are conditions that, although less likely, are critical to diagnose due to their potential severity:
    • Intracranial hemorrhage or stroke: Though less common as a cause of unilateral hearing loss, these conditions can present with sudden onset of hearing loss and headache. Prompt diagnosis is crucial for treatment.
    • Multiple sclerosis: An autoimmune disease that can affect various parts of the brain and spinal cord, leading to a wide range of potential symptoms, including unilateral hearing loss and headache.

• Rare Diagnoses

  • Cerebellopontine angle (CPA) lesions other than acoustic neuroma: Other tumors or cysts in this area can cause similar symptoms to acoustic neuroma, including hearing loss and headache.
  • Superior semicircular canal dehiscence: A rare condition of the inner ear that can cause hearing loss, vertigo, and autophony (hearing internal sounds unusually loudly), sometimes accompanied by headache.
  • Ototoxicity: Certain drugs or chemicals can cause hearing loss, which might be accompanied by headache if the ototoxic substance also has neurotoxic effects.

Each of these diagnoses has a different set of implications for treatment and management, emphasizing the importance of a thorough diagnostic workup for patients presenting with unilateral hearing loss and headache.