Central Neurocytoma of the Lateral Ventricle Presenting with Chronic Headache: A Case Report of a Rare Intraventricular Tumor.

Background: Central neurocytoma is an uncommon intraventricular neuronal tumor that usually behaves in a benign manner and primarily affects young adults. It most often originates from the septum pellucidum or the walls of the lateral ventricles and typically manifests with features of raised intracranial pressure. Because its clinical presentation is often nonspecific, it may initially be misdiagnosed as a primary headache disorder, leading to delays in appropriate evaluation. Case Presentation: We describe a 24-year-old woman without significant prior medical history who experienced severe, progressively worsening headaches over two years, initially treated as migraine. During her illness, she developed left-sided weakness, generalized fatigue, and visual complaints. On admission, neurological examination did not demonstrate focal motor or sensory deficits, cranial nerve involvement, or papilledema. Brain magnetic resonance imaging revealed a large intraventricular lesion measuring 5.4×4.2 × 4 cm that expanded the body of the right lateral ventricle and was attached to the septum pellucidum. She underwent a right frontal craniotomy with microsurgical excision of the mass. Histopathology showed uniform round cells with finely stippled chromatin in a neuropil-like background and numerous delicate capillaries, findings consistent with central neurocytoma. Her postoperative course was uneventful, with gradual neurological improvement, and follow-up MRI demonstrated no residual or recurrent tumor. Conclusion: Central neurocytoma should be kept in mind in young patients who present with chronic, progressive headache, especially when the clinical picture is atypical for common primary headache syndromes. Early brain imaging is crucial for timely diagnosis, and gross total surgical resection offers favorable clinical and radiological outcomes.