Right hemispheric language dominance in a right-handed male with a right frontal tumor shown by functional transcranial Doppler sonography.
BACKGROUND
A 38-year-old, right-handed man with late-onset right frontal epilepsy due to a ganglioglioma and atypical right hemispheric language dominance is described.


METHODS
Language dominance was investigated with functional transcranial Doppler sonography (fTCD), and language localization with functional magnetic resonance imaging (fMRI).


RESULTS
During a word generation task, fTCD showed atypical right hemispheric language dominance, which was confirmed by fMRI using a semantic word comparison and a word stem completion task. This information helped to guide the resective procedure, which left the patient seizure-free and did not induce new deficits.


CONCLUSIONS
Functional TCD appears to be a useful and reliable screening tool for determining hemispheric language dominance, even in patients with atypical language representation. Functional MRI may be used to confirm fTCD results and further localize eloquent cortex.
Haag
A
A
Department of Neurology, Interdisciplinary Epilepsy Center, Philipps University, Marburg, Germany. haag@staff.uni-marburg.de
Preibisch
C
C
Sure
U
U
Knake
S
S
Heinze
S
S
Krakow
K
K
Rosenow
F
F
Hamer
H M
HM
D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis; D004292:Dominance, Cerebral; D005625:Frontal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology; D007839:Functional Laterality; D018303:Ganglioglioma / Q000175:diagnosis; D006801:Humans; D007802:Language; D008297:Male; D011300:Preoperative Care; D017585:Ultrasonography, Doppler, Transcranial