FunCtiOnAl mAgnetiC ResOnAnCe imAging in the pRe-OpeRAtive evAluAtiOn OF CeRebRAl vAsCulAR mAlFORmAtiOns ResOnAnCiA mAgnétiCA CeRebRAl FunCiOnAl en lA evAluACión pRequiRúRgiCA de mAlFORmACiOnes vAsCulARes
نویسندگان
چکیده
Objective: to describe our experience with pre-operative evaluation of intracranial vascular malformations using functional magnetic resonance (fmRi). Method: Assessment of eight patients with cerebral vascular malformations (seven arteriovenous malformations [Avm] and one cavernous malformation) referred for pre-operative fmRi mapping of the eloquent cortex. An oxygen level-dependent technique (bOld) was used to localize these areas in relation to the cerebral vascular malformation, applying different paradigms. Results: We found one Avm in the right mid-temporal lobe with distribution of the visual and spatial memory to the contralateral hippocampus and parahippocampus; one posterior left temporal Avm with activation of Wernicke’s area only; one left parietal Avm without compromise of the sensory or motor cortex; a cavernous malformation at the left angular gyrus with hemispheric language dominance on that side; one right thalamic Avm with no compromise of the eloquent cortex; one left periventricular Avm with bilateral language dominance; one small left occipital Avm with normal activation of the primary visual cortex and decreased activation of the visual association cortex; and one temporo-occipital Avm with left language dominance and neurovascular uncoupling. Conclusion: fmRi can be used to delineate the anatomical relationship between the lesion and the eloquent cortex, providing useful information for pre-operative planning, and the estimated risk of the intervention.
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