Abstract
A left-handed patient with a grade II left frontal lobe astrocytoma had spontaneous seizures causing speech arrest and uncontrolled right upper extremity movements. Word-generation functional MR (fMR) imaging showed activity nearly exclusively in the right inferior frontal gyrus. The clinical history of the speech arrest and the intraoperative mapping proved left-hemisphere language dominance. Tumor involvement of the left inferior frontal gyrus caused uncoupling of the blood oxygenation level-dependent (BOLD) and neuronal response, leading to the erroneous fMR imaging appearance of right-hemisphere language dominance. Discrepancies between BOLD and intraoperative mapping in areas near lesions illustrate the complementary nature of these techniques.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aphasia, Broca / diagnosis
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Aphasia, Broca / physiopathology*
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Astrocytoma / blood supply
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Astrocytoma / diagnosis
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Astrocytoma / physiopathology*
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Brain Mapping
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Brain Neoplasms / blood supply
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Brain Neoplasms / diagnosis
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Brain Neoplasms / physiopathology*
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Diagnosis, Differential
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Dominance, Cerebral / physiology*
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Echo-Planar Imaging
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Frontal Lobe / blood supply
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Frontal Lobe / physiopathology*
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Humans
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Image Processing, Computer-Assisted*
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Imaging, Three-Dimensional*
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Magnetic Resonance Imaging*
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Male
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Nerve Regeneration / physiology*
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Neuronal Plasticity / physiology*
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Neurons / physiology
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Oxygen Consumption / physiology
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Regional Blood Flow / physiology*
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Sensitivity and Specificity