Abstract
Neglect is a severe neuropsychological/neurological deficit that usually develops due to lesions of the posterior inferior parietal area of the right hemisphere and is characterized by a lack of attention to the left side. Our case is a proven right-handed, 30-year-old female patient with a low-grade glioma, which was located in the temporo-opercular region and also in the superior temporal gyrus of the right hemisphere. Upon presurgical planning, the motor, language, and visuospatial functions were mapped. In order to achieve this, the protocol for routine magnetic resonance imaging and navigated transcranial magnetic stimulation has been expanded, accordingly.
Highlights
Case reportRecent clinical studies suggest the important role of supramaximal safe tumor resection in increasing life expectancy of patients with low-grade gliomas
On functional MRI (fMRI), a right-sided subdominant activity appeared by the posterior-inferior margin of the lesion, besides the left-sided dominant Wernicke activation, which was not confirmed with nTMS (Fig. 2a)
Superior longitudinal fasciculus (FLS) and pyramidal tracts were intact by using diffusion tensor imaging (DTI) and fMRI—a finding confirmed by nTMS examination, too (Fig. 2b–d)
Summary
Case reportRecent clinical studies suggest the important role of supramaximal safe tumor resection in increasing life expectancy of patients with low-grade gliomas. During testing for neglect, 44 stimulation target points on the parietal region of the right hemisphere were defined, where a total of 140 stimuli were delivered while the patient was asked to evaluate the length of 80 differently midtransected line (‘equal’; ‘left’ = left is longer; ‘right’ = right is longer).
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