Displacement of hand representation to the contralateral hemisphere may predict neurologic recovery after arteriovenous malformation resection from the sensorimotor cortex

R. T. Gandhi, B. R. Bendok, J. Schweitzer, C. Getch, D. Gitelman, J. R. Meyer, T. B. Parrish, M. M. Mesulam, H. H. Batjer

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Patients who have an arteriovenous malformation (AVM) in the sensorimotor cortex can have displaced function. The significance of this finding and its relationship to recovery from surgery is not known. We present the case of a 21-year-old man with medically intractable seizures caused by a left motor cortex AVM. Functional magnetic resonance imaging (fMRI) displayed bilateral representation of right hand function that was greatest in the right hemisphere. The AVM was first embolized and then microsurgically resected. Although he developed a transient monoplegia of the right upper extremity and speech difficulties after surgery, his deficits improved dramatically within several days and ultimately completely resolved. We postulate that the displacement of hand functional representation to the hemisphere contralateral to the AVM may have been the reason for this patient's expeditious recovery. FMRI may help predict the risk of deficit and chances for recovery in patients who have AVMs in the eloquent cortex. This noninvasive physiologic technique may replace anatomic criteria of inoperability for vascular malformations.

Original languageEnglish (US)
Pages (from-to)246-249
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Volume9
Issue number5
DOIs
StatePublished - Jan 1 2000

    Fingerprint

Keywords

  • Arteriovenous malformation
  • Functional MRI
  • Sensorimotor cortex

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this