Vision can be affected, and radiographic abnormalities involving the orbits, chiasm, or optic nerves are often, but not always, seen. The most common complaint of patients with intracranial plasma cell hyperplasia is headache. Other signs and symptoms, such as weakness and seizures, depend on the size and location of the proliferation. There is no obvious gender predominance, and the mean age of reported cases is about 30. No clear consensus exists with regards to treatment but most authors advocate surgical excision first, with steroids, radiation, and other immunosuppressives as adjuncts, especially in cases where total resection is not possible.
Prognosis is usually good, with recurrences being rare after resection.
Clinical Follow-up Our patient received IV steroid and cyclophosphamide treatment at monthly intervals for three successive months after the surgery, and has been followed for about a year without evidence of recurrence. He continues to have headaches, but his follow up imaging shows only postoperative changes with improving minimal dural enhancement. Repeat spinal fluid studies have been normal. His vision in the left eye has improved, with disappearance of inflammatory cells from the vitreous. To date, a potential infectious cause for his inflammatory process has not been identified, although continued surveillance is warranted.