The patient a Libyan citizen came to the clinic 19-May-2004 complaining of tinnitus left ear for three months with headache, insomnia and fainting attacks with blurring vision. MRI of the brain done 09-May-2004 showing tumor of the right parieto-occipital area reaching the lateral ventricle.

On examination: the patient has paresis of the left upper and lower limbs with Hoffman sign positive in the left.

Osteoplastic craniotomy over the right occipito-parietal area with reflection of the flap to the right ear. The dura opened and transcortical incision done at the most near locating tumor. The tumor was friable in consistency and different in color. Fresh frozen section gave the result of high-grade oligodendroglioma. Using the anatomical landmarks, total resection of the tumor was achieved. The lateral ventricle and parts of the tumor involving the choroid plexus was coagulated. Strict hemostasis. Water-tight closure of the dura and routine closure of the wound. Smooth postoperative recovery and the patient sent to the ICU for 24 hours observation.

The patient came to the clinic 09-June-2004  with some improvement of his left sided paresis and he was advised to undergo radiotherapy.

Thee patient then came 29-July-2004 after performing radiotherapy with full power of his left limbs.

The patient over the years came several times and MRI brain done 27-December-2005, 10-September-2006 and 25-July-2007 were free of recurrence. and neurologically free.

The patient then came 14-September-2008 with MRI done 30-August-2008 showing small mass with hemosiderin ring at the right parietal near posterior horn without mass effect. He was advised to undergo surgery with resection and application of Gliadel wafers, but he disappeared.

Oligodendroglioma is radiosensitive and in case of transformation to glioblastoma multiforme, resection with Gliadel wafers is the best offer.