Gangliogliomas: clinical study and evolution

We present 11 patients with intracranial gangliogliomas. The age ranged between 4 and 69 years with a mean of 32 years. The most frequent clinical manifestations were epilepsy in 7 cases and headache in 4 cases, and had begun from 15 days to 12 years before diagnosis. The gangliogliomas were located supratentorially predominantly in the temporal lobe (5 cases), except one, which was located within the cerebellum, which is extremely rare. EEG evidenced focality in 8 cases. The CT scan showed hypo or isodense images which were often associated with cysts, and that partially or totally enhanced with contrast administration in 7 cases (63.3%). Calcification was seen in only one case (9%). All our cases were treated surgically. Three patients were reoperated for recurrence. One case was reoperated twice and the histologic study showed astrocytoma grade II. Radiotherapy was given in two cases. In one case after subtotal surgery and in the other after the second operation for recurrence. Follow-up ranged between one and thirteen years, with a mean of 6.8 years. There was only one death. We used the CT scan for follow-up. However, nowadays MRI is more useful than the CT scan to distinguish recurrences.