The differential diagnosis will vary in detail according to the particular tumour being considered, but in general should include all other causes of intracranial mass lesions:
- vascular origin:
- haematoma
- giant aneurysm
- arteriovenous malformation
- infarction with oedema
- venous thrombosis
- (migraine - vascular aetiology still uncertain)
- trauma:
- infection:
- abscess
- tuberculoma
- sarcoidosis
- encephalitis
- cysts
There are several broad symptomatological clues that restrict the choice of differentials (1):
- vascular lesions, e.g. infarction / haemorrhage, are rapid in onset, produce a substantial deficit initially, and generally improve with time
- migraine rarely presents for the first time in adult life and may give a history of intermittent headache of duration longer than one year
- abscesses usually have a short history from the onset of symptoms, may be secondary to an obvious penetrating focus, and can present with no systemic signs of infection
- cysts: arachnoid cysts are not usually progressive; parasitic cysts usually have a history of geographical exposure to the infective agent.
Reference:
- Marks, S. (1993). Diagnosis and management of intracranial tumours. Surgery. Vol.11:10, 517-522.