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The Artery of Aphasia, A Uniquely Sensitive Posterior Temporal Middle Cerebral Artery Branch that Supplies Language Areas in the Brain: Anatomy and Report of Four Cases
- Source :
- World Neurosurgery. 126:e65-e76
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background Arterial disruption during brain surgery can cause devastating injuries to wide expanses of white and gray matter beyond the tumor resection cavity. Such damage may occur as a result of disrupting blood flow through en passage arteries. Identification of these arteries is critical to prevent unforeseen neurologic sequelae during brain tumor resection. In this study, we discuss one such artery, termed the artery of aphasia (AoA), which when disrupted can lead to receptive and expressive language deficits. Methods We performed a retrospective review of all patients undergoing an awake craniotomy for resection of a glioma by the senior author from 2012 to 2018. Patients were included if they experienced language deficits secondary to postoperative infarction in the left posterior temporal lobe in the distribution of the AoA. The gross anatomy of the AoA was then compared with activation likelihood estimations of the auditory and semantic language networks using coordinate-based meta-analytic techniques. Results We identified 4 patients with left-sided posterior temporal artery infarctions in the distribution of the AoA on diffusion-weighted magnetic resonance imaging. All 4 patients developed substantial expressive and receptive language deficits after surgery. Functional language improvement occurred in only 2/4 patients. Activation likelihood estimations localized parts of the auditory and semantic language networks in the distribution of the AoA. Conclusions The AoA is prone to blood flow disruption despite benign manipulation. Patients seem to have limited capacity for speech recovery after intraoperative ischemia in the distribution of this artery, which supplies parts of the auditory and semantic language networks.
- Subjects :
- Adult
Male
Middle Cerebral Artery
medicine.medical_specialty
Ischemia
Infarction
Temporal lobe
03 medical and health sciences
0302 clinical medicine
Aphasia
medicine
Humans
Aged
Language
Retrospective Studies
Brain Mapping
Language Disorders
medicine.diagnostic_test
Brain Neoplasms
business.industry
Infarction, Middle Cerebral Artery
Magnetic resonance imaging
Glioma
Middle Aged
medicine.disease
Magnetic Resonance Imaging
medicine.anatomical_structure
Middle Cerebral Artery Branch
Cerebrovascular Circulation
030220 oncology & carcinogenesis
Gross anatomy
Female
Surgery
Autopsy
Neurology (clinical)
Radiology
medicine.symptom
business
Craniotomy
030217 neurology & neurosurgery
Artery
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 126
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....eecd818e890dddf682d5d5c9157ee74d