A Woman in Her 40s With Headache and New-Onset Seizures.

Graham, Maya S; Pudusseri, Anita; Helgager, Jeffrey; Narendra, Derek P; De Girolami, Umberto; Pinkus, Geraldine S; Sanchorawala, Vaishali; Miyawaki, Edison · JAMA Neurol · 2017

case_report · Level V

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Abstract

A woman in her 40s with a history of plasma cell leukemia presented with 1 month of intermittent headaches followed by a seizure. Results from laboratory studies were notable for a cerebrospinal fluid opening pressure of 28 mm H2O and 8 white blood cells, including 1 atypical plasma cell. Imaging studies revealed confluent bifrontal white matter fluid-attenuated inversion recovery hyperintensities, as well as a contrast-enhancing sellar lesion. The patient underwent a stereotactic biopsy. The differential diagnosis, pathologic findings, and diagnosis are discussed.

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