Gangliogliomas are rare benign tumors, with only one percent (1 %) occurring in the central nervous system. Intracranially it occurs most commonly in the temporal area with seizures as its primary symptom. Neuroimaging has nonspecific findings. On MRI, it has low intensity on T1 and high intensity on T2-weighted images6. It may show a well-defined cystic mass with a solid mural nodule and may have calcifications in 30%. Management would include total resection of the tumor but prognosis would be greatly influenced by the tumor grade, location and margination. It is generally indolent and associated with a favorable prognosis. The purpose of this case report is to document this rare brain tumor with an atypical presentation.

We report the case of a 3 Y2 year old boy who manifests with intermittent upward ocular bobbing since 2 years of age, associated with intention tremor and frequent falls to the left. Neuroimaging revealed a solid mass involving the left cerebellar hemisphere, vermis, superior and middle cerebellar peduncles, partially extending to the left dorsal pons and midbrain with mild obstructive hydrocephalus. He then underwent ventriculoperitoneal shunting and biopsy revealed ganglioglioma,
WHO grade I.