TY - JOUR AU - Mauler, Jörg AU - Neuner, Irene AU - Neuloh, Georg AU - Fimm, Bruno AU - Boers, Frank AU - Wiesmann, Martin AU - Clusmann, Hans AU - Langen, Karl-Josef AU - Shah, N. J. TI - Dissociated Crossed Speech Areas in a Tumour Patient JO - Case reports in neurology VL - 9 IS - 2 SN - 1662-680X CY - Basel PB - Karger M1 - FZJ-2017-04604 SP - 131 - 136 PY - 2017 AB - In the past, the eloquent areas could be deliberately localised by the invasive Wada test. The very rare cases of dissociated crossed speech areas were accidentally found based on the clinical symptomatology. Today functional magnetic resonance imaging (fMRI)-based imaging can be employed to non-invasively localise the eloquent areas in brain tumour patients for therapy planning. A 41-year-old, left-handed man with a low-grade glioma in the left frontal operculum extending to the insular cortex, tension headaches, and anomic aphasia over 5 months underwent a pre-operative speech area localisation fMRI measurement, which revealed the evidence of the transhemispheric disposition, where the dominant Wernicke speech area is located on the left and the Broca’s area is strongly lateralised to the right hemisphere. The outcome of the Wada test and the intraoperative cortico-subcortical stimulation mapping were congruent with this finding. After tumour removal, language area function was fully preserved. Upon the occurrence of brain tumours with a risk of impaired speech function, the rare dissociate crossed speech areas disposition may gain a clinically relevant meaning by allowing for more extended tumour removal. Hence, for its identification, diagnostics which take into account both brain hemispheres, such as fMRI, are recommended. LB - PUB:(DE-HGF)16 UR - <Go to ISI:>//WOS:000411508700003 C6 - pmid:28626411 DO - DOI:10.1159/000475882 UR - https://juser.fz-juelich.de/record/834701 ER -