Affiliation:
1. Departments of Neurosurgery and
2. Neurology, NYU Langone Health, New York, New York
Abstract
BACKGROUND
Disruptions of the inferior longitudinal fasciculus (ILF) in the nondominant temporal lobe can lead to the rare but significant higher visual-processing disturbance of prosopagnosia. Here, the authors describe a 57-year-old right hand-dominant female with a large breast cancer brain metastasis in the right temporal lobe who underwent resection and subsequent Gamma Knife radiosurgery. She presented with difficulty with facial recognition, but following surgical intervention, the prosopagnosia became more profound.
OBSERVATIONS
Even in nondominant cortex, significant deficits can arise when operating near higher visual-processing centers, including the ILF.
LESSONS
This case highlights the utility of imaging-based tractography obtained from preoperative imaging for resective surgical planning even when operating in areas that do not involve what is traditionally considered elegant areas of the brain. To optimize neurological outcomes in metastatic tumor resection, awareness and diffusion tensor imaging of neighboring, displaced white matter tracts may prevent permanent deficits in higher visual processing.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Subject
Management Science and Operations Research,Mechanical Engineering,Energy Engineering and Power Technology