title: Left or right temporal lesion might induce aggression or escape during awake surgery, respectively: role of the amygdala.
abstract: OBJECTIVE
  Some patients with temporal lobe brain tumours show aggressive or escape behaviour during awake surgery. As the amygdala plays a critical role in coping with stress, we evaluated whether the left or right amygdala was involved in aggressive or escape behaviour in six patients undergoing awake surgery for temporal lobe brain tumours.
  
  
  METHODS
  Brain tumours were located in the left temporal lobe in cases 1-3 and in the right temporal lobe in cases 4-6. In cases 1, 2, 4 and 5, the tumours invaded the amygdala.
  
  
  RESULTS
  In case 1, the patient showed aggressive behaviour before partial removal of the left amygdala during awake surgery; just after partial removal of left amygdala, the patient was calm and cooperative. In case 2, the patient showed aggressive behaviour when the tumour near the left amygdala was removed. In case 3, the patient showed aggressive behaviour when awakening during awake surgery. In case 4, the patient showed escape behaviour when removal of the tumour near the right amygdala was initiated. In cases 5 and 6, patients showed escape behaviour upon awakening and upon initiation of tumour removal from the temporal lobe.
  
  
  CONCLUSIONS
  In conclusion, these results suggest that left or right temporal lesions might induce aggressive or escape behaviour during awake surgery, respectively, and that the amygdala on the respective side may play a role in these behaviours.
authors.affiliation: Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan.
authors.forename: Nobusada
authors.initials: N
authors.lastname: Shinoura
authors.affiliation: Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan.
authors.forename: Ryozi
authors.initials: R
authors.lastname: Yamada
authors.affiliation: Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tabei
authors.affiliation: Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Otani
authors.affiliation: Department of Psychology, Chuo University of Literature, Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Itoi
authors.affiliation: Department of Psychology, Chuo University of Literature, Tokyo, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Psychology, Chuo University of Literature, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Midorikawa