Differential Diagnosis
- Single most likely diagnosis
- Meningioma with associated inflammation: The presence of an osteomeningioma, headaches, brain fog, memory loss, and a thermograph scan showing the area of the brain as red suggest an inflammatory process related to the tumor. The fact that the MRI without contrast shows no compression does not rule out inflammation or other effects of the tumor on surrounding brain tissue.
- Other Likely diagnoses
- Cranio-cervical instability: Given the patient's symptoms and history, cranio-cervical instability could be contributing to her headaches, brain fog, and memory loss. This condition may also be related to or exacerbated by the osteomeningioma.
- Hormone-related complications: The long-term use of progesterone pills could have various effects on the body, including potential impacts on the brain and nervous system, which might contribute to her symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Brain abscess or infection: Although less likely, an infection in the brain could present with similar symptoms, including fever (which could explain the hot forehead), headaches, and cognitive changes. Missing this diagnosis could be fatal.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which could be related to the osteomeningioma or a separate infectious process.
- Venous sinus thrombosis: A blood clot in the venous sinuses of the brain, which could be a complication of the tumor or hormone therapy, and would require urgent treatment.
- Rare diagnoses
- Neurosarcoidosis: A rare condition where granulomatous inflammation affects the nervous system, which could mimic some symptoms of the patient's condition, including brain inflammation and cranial nerve involvement.
- Cerebral vasculitis: Inflammation of the blood vessels in the brain, which could be related to the tumor or an autoimmune process, and would require specific treatment to prevent further damage.