O. Taibi, H. Bennani, H. Retal, N.Ech-chrif Kettani, M.Fikri, F.Touarsa
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/31
Tectal plate gliomas are uncommon low-grade brain tumors that typically present with obstructive hydrocephalus, while optic pathway gliomas are among the most frequent central nervous system tumors associated with neurofibromatosis type 1 (NF1). We describe an 11-year-old boy who presented with progressive macrocephaly. Clinical examination revealed multiple café-au-lait macules, decreased visual acuity in the right eye, and a family history of NF1. Brain magnetic resonance imaging (MRI) demonstrated a well-circumscribed 5 × 6 × 6 mm tectal plate lesion that was hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR sequences, without diffusion restriction or post-contrast enhancement, causing aqueductal obstruction and triventricular hydrocephalus without transependymal cerebrospinal fluid permeation. MRI also showed fusiform enlargement of the intraorbital segment of the right optic nerve with T2/FLAIR hyperintensity and no contrast enhancement. These imaging findings were highly suggestive of a tectal plate glioma associated with a right optic nerve glioma in the setting of NF1. This case highlights the essential role of MRI in identifying the cause of obstructive hydrocephalus, detecting associated NF1-related intracranial tumors, and guiding appropriate clinical management and imaging surveillance.
Neurofibromatosis type 1; Tectal glioma; Optic nerve glioma; Obstructive hydrocephalus; Magnetic resonance imaging
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