• Nobusada Shinoura, Toshiyuki Onodera, Kotoyo Kurokawa, Masanobu Tsukada, Ryozi Yamada, Yusuke Tabei, Tomoyuki Koizumi, and Kazuo Yagi.
• Department of Neurosurgery, Komagome Metropolitan Hospital, Bunkyo-ku, Tokyo, Japan. shinoura@cick.jp
• Eur. Neurol. 2010 Jan 1;64(4):224-9.

AbstractAnalysis of lesions and symptoms in patients with brain tumors combined with information from diffusion tensor imaging provides direct evidence of the anatomical localization of brain function. Using these methods, we evaluated 8 patients who underwent surgery for metastatic brain tumors located in the left occipital lobes between 2007 and 2009. Preoperatively, 4 patients (cases 1-4) had alexia with agraphia while the other 4 patients (cases 5-8) did not. Tractography for the superior longitudinal fasciculus (SLF) was performed before surgery in case 1. The common brain tumors in cases 1-4 were located in the upper portion of area 19, and peritumor edema in that area resulted in compromise of the deep white matter of the inferior parietal lobe (IPL). The SLF was compressed and disrupted in the white matter of the IPL near the upper portion of area 19 in case 1. In cases 5-8, the brain tumors were not located in the upper portion of area 19. These results suggest that damage to the upper portion of area 19 and to the white matter in the left IPL, including the SLF, resulted in alexia with agraphia.Copyright © 2010 S. Karger AG, Basel.

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