Functional magnetic resonance imaging in adult craniopagus for presurgical evaluation.
Cranially conjoined twins are rare and pose unique challenges in the preoperative evaluation of cerebral language function. The authors report on their experience in the functional magnetic resonance (fMR) imaging evaluation of adult craniopagus (temporoparietooccipital fusion) to evaluate hemispheric language dominance and the eloquent language areas in the preoperative planning stages. Conventional clinical imaging hardware originally designed for individuals was adapted and tailored for use in the twins. They were assigned a selection of language tasks while undergoing fMR imaging. Significant blood oxygen level-dependent activations were detected in the main language regions in each twin, that is, the inferior frontal gyrus (around the Broca area), the middle and superior temporal lobes (around the Wernicke area) together with the inferior parietal lobe, and the middle and superior frontal gyri. Overall, the right-handed twin was strongly left lateralized for language, whereas the left-handed twin showed more bilateral activation during language tasks. Noninvasive language mapping with the aid of fMR imaging has been demonstrated for the first time in total craniopagus.
Ho
Yi-Ching Lynn
YC
Departments of Neuroradiology, Research, and Neurology, National Neuroscience Institute, Singapore.
Goh
Keith Yu-Ching
KY
Golay
Xavier
X
Hong
Wee-Tin
WT
Lim
Shih-Hui
SH
Pan
Andrew Beng-Siong
AB
Chua
Violet Gek-Eng
VG
Hui
Francis
F
Sitoh
Yih-Yian
YY
D000328:Adult; D001921:Brain / Q000473:pathology* / Q000601:surgery*; D001931:Brain Mapping; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D011300:Preoperative Care; D014428:Twins, Conjoined / Q000473:pathology* / Q000601:surgery*