Intraventricular Ganglioglioma Presenting with Spontaneous Hemorrhage

• Main Authors: Alexandre Rainha Campos, Luisa Biscoito, Maria Gabriela Gasparinho
• Format: Article
• Language: English
• Published: Ordem dos Médicos 2018-03-01
• Series: Acta Médica Portuguesa
• Subjects: Cerebral Ventricle Neoplasms; Diffusion Tensor Imaging; Epilepsy; Ganglioglioma/surgery
• Online Access: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/8943

Intraventricular gangliogliomas presenting with spontaneous hemorrhage are rare. Due to high density of important tracts lateral to the ventricular atrium, the intraparietal trans sulcal approach is a good option to remove lesions in this location. These tracts are displaced and sometimes destroyed by the presence of large masses. A 33-year-old male presented with a sudden headache and a generalized seizure. He had a left visual field hemianopia and left visual field neglect. Brain computer tomography and magnetic resonance imaging revealed a hemorrhagic tumor located in his right atrium. With the help of tractography an optimal corridor to the tumor through the intraparietal sulcus was planned. Gross total removal of a ganglioglioma was possible with recovery of visual impairment and control of epilepsy. The efficacy in using tractography as a planning tool for safe tumor removal is demonstrated with clinical, imagiological and histological data, and a surgical video.