title: Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia.
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.
authors.affiliation: Division of Neuroradiology, Department of Diagnostics and Applied Technology, Foundation IRCCS National Neurological Institute C. Besta, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vitali
authors.forename: Nina
authors.initials: N
authors.lastname: Dronkers
authors.forename: Alexander
authors.initials: A
authors.lastname: Pincherle
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Giovagnoli
authors.forename: Carlo
authors.initials: C
authors.lastname: Marras
authors.forename: Ludovico
authors.initials: L
authors.lastname: D'Incerti
authors.forename: Francesco
authors.initials: F
authors.lastname: Ghielmetti
authors.forename: Roberto
authors.initials: R
authors.lastname: Spreafico
authors.forename: Flavio
authors.initials: F
authors.lastname: Villani
mesh_terms: D000328:Adult; D001037:Aphasia / Q000175:diagnosis* / Q000209:etiology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D001931:Brain Mapping; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D013997:Time Factors
chemical_list: D010100:Oxygen