Department of Neuroradiology,Centre Hospitalier Sainte-Anne, Paris, FranceKey words: corticospinal tract, descending pathways, dissemination, glioma, white matter fiber tractsA 25-year-old right-handed woman, without anymedical history, was presented with a two-monthhistory of headaches. Neurological examinationwas unremarkable apart from signs of intracranialhypertension. The fundoscopy showed bilateral pap-illedema.The MRI demonstrated a multifocal heterogeneousmass, involving both frontal lobes, corpus callosum andthe basal ganglia on the right-hand side. The mass washypointense on T1-weighted images, contrast enhancedafter gadolinium injection, and hyperintense on T2-weighted and fluid-attenuated inversion recovery(FLAIR) images. The T2-weighted and FLAIR imagesdemonstrated an area of hyperintense signal locatedalong the left corticospinal tract (Figure 1). An incom-plete resection of the left frontal part of the tumor wasperformed. Pathological examination revealed an oli-godendroglioma WHO grade III and Sainte AnneClassification grade B [1]. The postoperative manage-ment consisted in Temozolomide chemotherapy andexternal conformational radiotherapy. Six months aftersurgery, neurological examination revealed a rightpyramidal syndrome without any motor deficit. Thepatient is still under therapy.