Intraventricular schwannoma presenting with memory impairment and full neurological recovery after surgical resection: a case report

BACKGROUND: Intraventricular schwannomas are exceptionally rare benign tumors, accounting for a minute fraction of intracranial schwannomas. Their occurrence within the lateral ventricle is particularly uncommon, and the clinical presentation is often nonspecific, posing significant diagnostic challenges. To date, only a limited number of cases have been reported worldwide. We present a rare case of a left lateral ventricular schwannoma manifesting predominantly as transient isolated memory impairment, an unusual presentation that broadens the recognized clinical spectrum of this entity. CASE PRESENTATION: A 44-year-old woman of Flemish origin presented with a two-day history of transient memory impairment without any identifiable precipitating factor. The episode was associated with a single vomiting event and an isolated fever spike on the preceding day. She denied focal neurological deficits, headaches, seizures, visual disturbances, or other systemic symptoms. Her medical history was notable only for childhood epilepsy that had completely resolved by the age of 12 years. Neurological and general physical examinations were normal. Magnetic resonance imaging revealed a well-circumscribed intraventricular mass located in the left lateral ventricle, radiologically suggestive of a benign neoplasm. Electroencephalography showed no epileptiform abnormalities. Following preoperative corticosteroid therapy, the patient underwent neuronavigation-assisted left parietal craniotomy with gross-total microsurgical resection of the lesion. Histopathological examination confirmed the diagnosis of schwannoma. The post-operative course was uneventful, and the patient achieved complete neurological recovery without residual memory deficits or new neurological impairments. CONCLUSIONS: This case highlights the exceptional rarity of intraventricular schwannomas and demonstrates that isolated transient memory impairment may represent an atypical presenting manifestation. Complete microsurgical excision remains the treatment of choice and is associated with excellent neurological outcomes. Awareness of this rare diagnosis may facilitate earlier recognition and appropriate management of unusual intraventricular lesions, thereby expanding current understanding of the clinical spectrum of intraventricular schwannomas.