What is the diagnosis for a 44-year-old woman with a meningioma (tumor) on the frontal lobe, possibly due to long-term progesterone (hormone) therapy for menorrhagia (heavy bleeding), presenting with headaches, brain fog, memory loss, and a sensation of heat on the forehead, with a thermograph scan showing hyperthermia (increased temperature) in the affected area and an MRI (Magnetic Resonance Imaging) without contrast showing no compression?

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Differential Diagnosis

  • Single most likely diagnosis
    • Meningioma with associated symptoms: The patient has an established diagnosis of osteomeningioma on the frontal lobe, which is likely causing her symptoms of headaches, brain fog, and memory loss. The thermograph scan showing a red area in the brain supports this diagnosis, as it may indicate increased blood flow or inflammation associated with the tumor.
  • Other Likely diagnoses
    • Cranio-cervical instability: The patient's symptoms and history suggest possible cranio-cervical instability, which could be contributing to her headaches and other symptoms.
    • Hormone-related complications: The patient's long-term use of progesterone pills for heavy bleeding may be related to the development of the osteomeningioma, and hormonal imbalances could be contributing to her symptoms.
    • Migraines or other headache disorders: The patient's headaches and sensitivity to heat could be indicative of a migraine or other headache disorder.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Brain edema or swelling: Although the MRI without contrast shows no compression, it is essential to rule out brain edema or swelling, which could be life-threatening if left untreated.
    • Venous sinus thrombosis: The patient's symptoms and history of hormone use increase her risk for venous sinus thrombosis, which is a potentially life-threatening condition.
    • Pituitary apoplexy: Although less likely, pituitary apoplexy is a rare but potentially life-threatening condition that could present with similar symptoms.
  • Rare diagnoses
    • Neurosarcoidosis: This rare condition could present with similar symptoms, including headaches, brain fog, and memory loss, although it is less likely given the patient's established diagnosis of osteomeningioma.
    • Cerebral vasculitis: This rare condition could cause similar symptoms, including headaches and sensitivity to heat, although it is less likely given the patient's history and established diagnosis.

Professional Medical Disclaimer

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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