gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Atypical right hemispheric language dominance in a right-handed male with a right frontal ganglioglioma determined by fTCD and fMRI

Mittels fTCD und fMRT bestätigte atypische rechtshemisphärische Sprachdominanz bei einem rechtshändigen Patienten mit rechts frontalem Gangliogliom

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  • corresponding author A. Haag - Klinik für Neurologie, Universität Marburg
  • U. Sure - Klinik für Neurochirurgie, Interdisziplinäres Epilepsiezentrum Marburg, EZM, Universität Marburg
  • S. Knake - Klinik für Neurologie, Universität Marburg
  • S. Heinze - Klinik für Neurochirurgie, Interdisziplinäres Epilepsiezentrum Marburg, EZM, Universität Marburg
  • K. Krakow - Klinik für Neurologie und Brain Imaging Center, J.W. Goethe University Frankfurt
  • H. M. Hamer - Klinik für Neurologie, Universität Marburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP005

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0273.shtml

Published: May 4, 2005

© 2005 Haag et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Information about the localization of speech-relevant brain areas helps to spare those areas during a resective neurosurgical procedure. However, an easily applicable, cost efficient and non-invasive tool to determine speech dominance is not yet widely established.

Methods

A word-generation task was used for language lateralization with the help of functional transcranial Doppler sonography (fTCD). The results were confirmed with functional magnetic resonance imaging (fMRI) applying a semantic word comparison and a word stem completion task.

Results

We report on a 38-year old right-handed male suffering from right frontal epilepsy due to a ganglioglioma. FTCD repeatedly showed atypical right hemispheric speech dominance. Functional magnetic resonance imaging (fMRI) confirmed this finding. It was fused with the structural MRI and contributed, thus, in guiding the resective procedure which left the patient seizure-free without inducing new deficits.

Conclusions

The present case supports the view that inclusion of testings for hemispheric language dominance in the presurgical evaluation may be appropriate, when resections are planned near cortex which is potentially involved in language function. Functional TCD appears to be a useful and reliable screening tool to test for hemispheric language dominance even in patients with atypical language representation. Functional MRI may be used to confirm fTCD results and further localize the eloquent cortex.