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. 2018 Jun 5;9:400. doi: 10.3389/fneur.2018.00400

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Copyright © 2018 Rosazza, Deleo, D'Incerti, Antelmi, Tringali, Didato, Bruzzone, Villani and Ghielmetti.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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DTI-tractography and fMRI tasks of arm and leg movement of the preoperative and postoperative assessment of Case 1 and Case 2. Case 1 presented with severe atrophy of the right hemisphere and corpus callosum. DTI-tractography revealed the CST (red) and somatosensory tract (yellow) also in the affected hemisphere, while inter-hemispheric fibers were not reconstructed. After surgery the CST was no longer visible and the right somatosensory tract was recognized only between the brainstem and the thalamus. FA color-maps at the pons showed some asymmetry in the CST (anterior pair of blue) preoperatively, and a completely lateralized pattern postoperatively. Before surgery fMRI activations of the paretic arm and leg showed involvement of the right and left primary motor areas, with strong engagement of the intact SMA. After surgery, activations shifted to the intact hemisphere. Case 2 presented with a large frontal malacic area in the right hemisphere and a smaller one in the left hemisphere. DTI-tractography revealed the CST (red) and the somatosensory tract (yellow) also in the affected hemisphere, and inter-hemispheric fibers connecting homologous motor regions. After surgery, the right CST was no longer visible and the right somatosensory tract is recognized only between the brainstem and the thalamus. FA color-maps at the pons showed some asymmetry in the CST (anterior pair of blue) preoperatively, and a completely lateralized pattern postoperatively. Before surgery fMRI activations of the paretic arm and leg showed stronger involvement of the right than left primary motor areas, with engagement of the intact SMA. After surgery, activations shifted to the intact hemisphere, involving peri-rolandic areas.