Male, 8 years old, with brain tumor and epilepsy. Functional MRI and DTI requested for surgical planning. Sensorimotor cortical activation of the lower extremity/foot was unreliably visualized despite repeat attempts. Sensorimotor cortical activation of the hand and face/tongue was adequately visualized and maps as expected along the pre- and post-central gyri. Passive visual stimulation produced cortical activity as expected along the calcarine sulci.Of the tested language paradigms, the most reliable language related cortical activation was seen with the verb generation and sentence completion paradigms. Language is left dominant. Wernicke's area is well visualized on the sentence completion paradigm mapping along the posterior aspect of the left superior temporal sulcus. Broca's area is well visualized on the verb generation paradigm with several foci of activity in the left inferior frontal lobe. Both paradigms demonstrate expected secondary language activity in the left middle frontal gyrus and in the left SMA.The auditory word listening paradigm also demonstrates Wernicke's area in its expected location on the left. In addition, activation of primary auditory cortex is seen bilaterally along the superior surfaces of the superior temporal gyri. On the right, this activity maps immediately posterior and superior to the patient's temporal lobe tumor.
1.Sensorimotor cortical mapping of hand and facial motor activity was successful. Sensorimotor cortical mapping of the foot/lower extremity could not be achieved with adequate reliability. Primary visual cortical activity mapped as expected to the occipital lobes.2.Language mapping demonstrates left hemispheric dominance. Broca's and Wernicke's areas mapped to their expected locations as above.3.Auditory stimulation demonstrates the location of primary auditory cortex along the superior surfaces of the superior temporal gyri bilaterally. On the right, this activity maps immediately posterior and superior to the patient's right temporal tumor.