Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH). After surgery, a right subdural hematoma caused epileptic status and severe aphasia. This post-surgical complication of a crossed aphasia confirmed the prior fMRI findings of RH language thus stressing the value of pre-surgical fMRI evaluations, even when surgery is planned in the RH of a right-handed patient.

Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia / P. Vitali, N. Dronkers, A. Pincherle, A.R. Giovagnoli, C. Marras, L. D'Incerti, F. Ghielmetti, R. Spreafico, F. Villani. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 32:1(2011 Feb), pp. 175-180. [10.1007/s10072-010-0426-y]

Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia

P. Vitali
Primo
;
F. Ghielmetti;
2011

Abstract

Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH). After surgery, a right subdural hematoma caused epileptic status and severe aphasia. This post-surgical complication of a crossed aphasia confirmed the prior fMRI findings of RH language thus stressing the value of pre-surgical fMRI evaluations, even when surgery is planned in the RH of a right-handed patient.
Crossed aphasia; Functional MRI; Hemispheric dominance; Language; Temporal lobe epilepsy
Settore MED/37 - Neuroradiologia
feb-2011
19-nov-2010
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/912645
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