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FIG 3. A–D, Assessing feasibility of surgery in an epilepsy patient, case 23 (Table 1): 9-year-old boy with medically intractable partial-onset seizures. Anatomic MR image shows a pial-based abnormality in the left perirolandic region (A), which enhanced with contrast (B). This was interpreted to represent a pial angioma of Sturge-Weber. Functional MR imaging was performed to determine the topographic relationship between the lesion and the functional hand area (C and D). This study, particularly the section illustrated in C, which is inferior to the section in D, showed functional activation located directly beneath the pial angioma. Invasive extraoperative stimulation mapping confirmed the location of hand function identified by the functional MR imaging study. Surgery was deferred. The scalp marker over the right parietal region in A and C is a fiducial for frameless stereotactic surgery
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