Female, 40 years old, with cavernoma, presenting with seizures, balance loss, intermittent expressive aphasia, double vision, fatigue, headaches and memory loss. Functional assessment requested for speech and motor to assess surgical risk. Sensorimotor cortical activation of the hand, foot and face maps as expected along the pre- and post-central gyri. Visual cortical activation maps along the bilateral calcarine sulci.Of the tested language paradigms, all produce reliable language related cortical activation. Language is strongly left dominant. The putative Broca's area is best visualized on the word generation paradigm and maps to the pars opercularis and pars triangularis of the left inferior frontal gyrus. The putative Wernicke's area is best visualized on the sentence completion paradigm and maps along the posterior aspect of the left superior temporal sulcus. Both Broca's and Wernicke's areas are visualized on the verb generation paradigm. All language related cortical activity is well removed from the visualized left medial temporal lobe lesion.
1.Sensorimotor cortical activation maps as expected along the pre and postcentral gyri. Visual cortical activation maps as expected along the bilateral calcarine sulci.2.Language is left dominant. Broca's and Wernicke's areas are identified in their customary locations.