• Daiki Uchida, Chikanori Inenaga, and Tokutaro Tanaka.
• Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
• World Neurosurg. 2020 Aug 1; 140: 303-307.

BackgroundMalformations of cortical development (MCDs) often result in mental retardation, intractable epilepsy, neurodevelopmental delay, and contralateral hemiparesis. We describe herein a rare patient with MCD who had developed normally in spite of diffuse hemispheric anomaly of the brain.Case DescriptionWe report a left-handed 20-year-old healthy man. A magnetic resonance image scan revealed congenital left cerebral hemispheric dysplasia and deficit of the normal anatomical primary motor cortices although he was normally developed without hemiparesis nor aphasia. Diffusion tensor tractography showed unusual fiber radiation from the left cerebral peduncle to the much more rostral and lateral cerebral cortices compared with normal anatomy. Right finger flexion-extension task showed activation in that area on functional magnetic resonance imaging.ConclusionsEven in a congenital hemispheric dysplasia, the contralateral fine finger movement may still depend on the dysplastic hemisphere. On the other hand, speech and the other gross movements including leg, foot, and arm can be compensated with the ipsilateral normal cerebral cortices.Copyright © 2020 Elsevier Inc. All rights reserved.

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