Artikel
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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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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.