Functional magnetic resonance imaging in adult craniopagus for presurgical evaluation

Yi Ching Lynn Ho, Keith Yu Ching Goh, Xavier Golay, Wee Tin Hong, Shih Hui Lim, Andrew Beng Siong Pan, Violet Gek Eng Chua, Francis Hui, Yih Yian Sitoh

Research output: Contribution to journalArticlepeer-review

Abstract

Cranially conjoined twins are rare and pose unique challenges in the preoperative evaluation of cerebral language function. The authors report on their experience in the functional magnetic resonance (fMR) imaging evaluation of adult craniopagus (temporoparietooccipital fusion) to evaluate hemispheric language dominance and the eloquent language areas in the preoperative planning stages. Conventional clinical imaging hardware originally designed for individuals was adapted and tailored for use in the twins. They were assigned a selection of language tasks while undergoing fMR imaging. Significant blood oxygen level-dependent activations were detected in the main language regions in each twin, that is, the inferior frontal gyrus (around the Broca area), the middle and superior temporal lobes (around the Wernicke area) together with the inferior parietal lobe, and the middle and superior frontal gyri. Overall, the right-handed twin was strongly left lateralized for language, whereas the left-handed twin showed more bilateral activation during language tasks. Noninvasive language mapping with the aid of fMR imaging has been demonstrated for the first time in total craniopagus.

Original languageEnglish (US)
Pages (from-to)910-916
Number of pages7
JournalJournal of neurosurgery
Volume103
Issue number5
DOIs
StatePublished - Nov 2005

Keywords

  • Blood oxygen level-dependent technique
  • Conjoined twins
  • Craniopagus
  • Functional magnetic resonance imaging
  • Language dominance
  • Language mapping

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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