title: Prosopagnosia Induced by a Left Anterior Temporal lobectomy Following a Right Temporo-occipital Resection in a Multicentric Diffuse Low-Grade Glioma.
abstract: BACKGROUND
  Face recognition is a complex function sustained by a distributed large-scale neural network, with a core system involving the ventral occipitotemporal cortex, the inferior longitudinal fasciculus (ILF), and the splenial commissural fibers. This circuit seems to be bilaterally organized, but with a right hemispheric dominance. According to this anatomic functional model, prosopagnosia is usually, but not exclusively, generated by a damage of the right part of this brain network.
  
  
  METHODS
  This report describes an original case of a multicentric diffuse low-grade glioma, with a right occipitotemporal tumor and a left anterior temporoinsular tumor. Awake surgery for the right occipitotemporal lesion, involving fusiform and inferior occipital gyri and ILF, was achieved in a first step without causing any neurologic deficit. A subsequent resection of the left anterior temporoinsular lesion, with removal of the anterior left ILF, was achieved 1 year later. Surprisingly, the patient experienced a strong and permanent prosopagnosia after this second surgery.
  
  
  CONCLUSIONS
  The authors investigate the possible causes resulting in this prosopagnosia. Specifically, they suggest a decompensation within a reorganized neural network after the first operation, because of a disconnection syndrome induced by a bilateral surgical damage of the ventral occipitotemporal structural connectivity. These original data can be useful for neurosurgeons, especially when achieving resection for multicentric tumors involving both ventral streams, to inform patients before surgery about the possible risk of face recognition deficit, and to adapt the cognitive tasks intraoperatively during awake procedure.
authors.affiliation: Department of Neurosurgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Corrivetti
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Institute for Neuroscience of Montpellier, INSERM 1051, "Team Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Montpellier University Medical Center, Montpellier, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Herbet
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Institute for Neuroscience of Montpellier, INSERM 1051, "Team Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Montpellier University Medical Center, Montpellier, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Moritz-Gasser
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Institute for Neuroscience of Montpellier, INSERM 1051, "Team Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Montpellier University Medical Center, Montpellier, France. Electronic address: h-duffau@chu-montpellier.fr.
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005910:Glioma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009778:Occipital Lobe / Q000601:surgery; D020238:Prosopagnosia / Q000175:diagnosis* / Q000209:etiology*; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome
keywords: Disconnection syndrome; Face recognition; Fusiform face area; Inferior longitudinal fascicle; Low-grade glioma; Prosopagnosia