Translocation of Broca’s area in a case of low-grade glioma: reinforcing the importance of preoperative functional magnetic resonance imaging

Abstract

Abstract Background Functional MRI has enabled us to map the anatomical location of functional areas of brain including language centers and thus provides useful insights in preoperative planning and assessment for neurosurgeons. In recent years, fMRI has also provided evidence for neuroplasticity which implies that brain pathways have an ability to reorganize in response to any injury. Case presentation We present a case of a 27-year-old male, postoperative case of left frontotemporal glioma (WHO grade II) with residual tumor in inferior frontal, temporal and insular lobe in whom functional magnetic resonance imaging was carried out to elicit language centers. fMRI revealed activation of Wernicke’s area in left cerebral hemisphere in the right-handed patient, while Broca’s area was activated in right cerebral hemisphere, thus eliciting the translocation of Broca’s area in response to low-grade glioma. Conclusions This case provided an example of the ability of brain to reorganize pathways in response to injury or insult. The routine use of preoperative fMRI in such cases will help in better planning and lead to an improved postoperative outcome.