• Ependymomas can present as multifocal tumors. 
• Intradural extramedullary ependymomas are very rare.
• Surgery and adjuvant radiation are a good treatment for high-grade ependymomas. 
Plain Language Summary 
    Ependymomas are rare tumors that originate from the central nervous system. Given their rarity, there are no clearly defined guidelines about their management, particularly in cases where tumors present in multiple regions of the brain and spinal cord. In this report, the authors present an interesting case of a 53-year-old male who presented to the emergency department with difficulty urinating and a sensation of incomplete bladder emptying. Imaging studies revealed the presence of tumors in the brain and spinal cord consistent with the diagnosis of ependymoma. The patient received surgery along with radiation therapy and has been in remission since. We hope the findings of our case report add valuable information to the field of medicine by raising awareness about these tumors and encouraging physicians to consider ependymomas on their differential diagnoses when evaluating patients. Additionally, given our success with treatment, we hope to contribute to the existing literature on the treatment of these tumors, and the development of management guidelines