Complex visual hallucinations as a presentation of temporal low-grade glioma

Area of Science:

• Neuro-oncology
• Neurology
• Ophthalmology

Background:

• Low-grade gliomas are primary brain tumors that can present with varied neurological symptoms.
• Visual disturbances can arise from lesions affecting the visual pathways or occipital cortex.
• Visual hallucinosis, characterized by complex visual perceptions, is typically associated with specific neurological or psychiatric conditions.

Purpose of the Study:

• To report an unusual case of temporal low-grade glioma presenting with visual hallucinosis.
• To highlight the atypical MRI findings in relation to the presenting symptoms.
• To discuss the diagnostic challenges and implications for neurosurgical management.

Main Methods:

• Case report of a single patient.
• Clinical presentation and neurological examination.
• Magnetic Resonance Imaging (MRI) for lesion characterization.
• Review of relevant literature.

Main Results:

• The patient exhibited formed, colored, meaningful visual hallucinations without psychiatric or epileptiform features.
• MRI revealed a temporal lobe low-grade glioma with an unusual location and extent.
• The lesion's characteristics differed from typical MRI findings associated with visual hallucinosis.

Conclusions:

• Temporal lobe low-grade gliomas can present atypically with visual hallucinosis.
• Unusual MRI findings in the temporal lobe should prompt consideration of glioma, even with visual symptoms.
• Accurate diagnosis through advanced imaging is crucial for appropriate treatment of brain tumors.