Tectal Plate Glioma Presenting With Intratumoral Hemorrhage

Area of Science:

• Neuro-oncology
• Neurosurgery

Background:

• Tectal gliomas are rare brainstem tumors.
• Obstructive hydrocephalus is a common complication due to mass effect on the cerebral aqueduct.
• Intratumoral hemorrhage within a tectal glioma is exceptionally rare.

Observation:

• A 43-year-old male with a known tectal plate glioma presented with acute obstructive hydrocephalus.
• The hydrocephalus was secondary to intratumoral hemorrhage within the glioma.
• The patient experienced rapid neurological decline, including diplopia and headaches.

Findings:

• Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed acute obstructive hydrocephalus and intratumoral hemorrhage.
• Endoscopic third ventriculocisternostomy (ETV) successfully diverted cerebrospinal fluid.
• Endoscopic biopsy revealed a low-grade glial tumor.
• Postoperative MRI showed reduced tumor size and stable ventriculomegaly.

Implications:

• This case underscores the rarity of intratumoral hemorrhage in tectal gliomas.
• Heightened clinical suspicion is crucial for diagnosing this rare complication.
• ETV is an effective treatment for hydrocephalus in these cases.
• Potential hemorrhagic complications necessitate close patient monitoring.