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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:493-497, March 2006
© 2006 American Society of Neuroradiology

Case Report
FUNCTIONAL

Presurgical and Intraoperative Mapping of the Motor System in Congenital Truncation of the Precentral Gyrus

C.V. Salvan^a, J.L. Ulmer^a, W.M. Mueller^b, H.G.J. Krouwer^c, R.W. Prost^a and G.O. Stroe^a

^a Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis
^b Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wis
^c Department of Neurology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wis

Address reprint requests and correspondence to John L. Ulmer, MD, Department of Radiology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226

SUMMARY: A 43-year-old man presented with a grade II astrocytoma in the left postcentral gyrus and superior parietal lobule. Preoperative functional MR imaging and diffusion tensor imaging mapped distal upper-extremity primary motor cortex and white matter, respectively, adjacent to the tumor, within a congenitally truncated precentral gyrus. Because of the congenital anomaly, this region of primary motor cortex was inaccessible to direct visualization or intraoperative electrocortical stimulation. The integration of preoperative and intraoperative mapping data facilitated resection of the tumor while avoiding a postoperative motor deficit.