fMRI of Pediatric Neurosurgery Patients

Success with fMRI for language mapping in pediatric epilepsy patients has led to the extension of the use of fMRI technology for other neurosurgical applications. In collaboration with the Division of Pediatric Neurosurgery at Children's Hospital Medical Center, the Imaging Research Center is performing fMRI of speech, hearing, motor control and/or vision in selected neurosurgery patients prior to and after neurosurgery.

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Brain tumors, arterial venous malformations, and hemorrhagic strokes are examples of conditions for which neurosurgery may be required to save a child's life. Functional MRI can be used prior to surgery to map out regions of the brain which are providing critical support for sensory motor and neurocognitive functions. FMRI activation maps can then help the neurosurgeons avoid disturbing eloquent brain regions, thereby minimizing the adverse side effects of the surgical procedures. An example of an activation map corresponding to speech and language recognition in a 14-year-old girl with a recurrent brain tumor is shown in Figure 1. The blue and green pixels indicate areas which are active during language tasks. Some of these pixels are close to the tumor and so the neurosurgeon exercised extra caution when resecting the tumor in this area. Outcome of the procedure was very good, with minimal impact on language functions.