The authors report the fourth case of primary intracranial plasma-cell granuloma. The patient was a 16-year-old girl who presented with loss of vision as the major clinical feature. The tumor resembled a meningioma both preoperatively and grossly at surgery. Because the tumor did not respond to steroid treatment following subtotal surgical excision, radiation therapy was administered to the affected area. Major considerations in the differential diagnosis of this neoplasm are discussed.
The authors discuss the gross and microscopic anatomy and the physiology of the cerebral venous system. Cerebral veins under pathological circumstances (hypercapnia, arterial hypertension, and increased intracranial pressure), pharmacological observations, the venous blood-brain barrier, and traumatic involvement are reviewed. Neoplastic involvement and radiological aspects are included. Surgical reconstruction of venous sinuses (including the Donaghy technique), tumor removal, sinus thrombectomy, and extraanatomical bypass of the transverse sinus are discussed.
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