Gangliogliomas represent a rare form of neuroepithelial tumor (up to 1.3% of brain tumors [1]), which even more rarely present with hemorrhage or localize intraventricularly. To date, only two cases of ganglioglioma with both of these features have been reported. Our patient is a 23-year-old woman who presented with signs and symptoms of increased intracranial pressure (ICPI), with a post-subtotal resection diagnosis of WHO Grade I ganglioglioma localizing bilaterally to the lateral ventricles. One year following the operation, the tumor showed radiologic evidence of interval hemorrhage, which was verified histopathologically following a second subtotal resection. Greater than 95% of the lesion represented a large hematoma with organization and well-defined fibrous pseudo-capsule, with very scanty fragments of adjacent/peripheral low-grade neuroglial tumor. This case represents a very rare presentation of intraventricular ganglioglioma with extensive hemorrhage.
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