Antonella Castellano1,2, Lorenzo Bello3, Enrica Fava3, Alessandra Casarotti3, Costanza Papagno4, Giorgio Carrabba3, Giuseppe Scotti1, Andrea Falini1
1Neuroradiology Unit and CERMAC, Scientific Institute and University Vita-Salute San Raffaele, Milan, MI, Italy; 2Institute of Radiological Sciences, University of Milano, Milan, MI, Italy; 3Neurosurgery, Department of Neurological Sciences, University of Milano, Milan, MI, Italy; 4Neuropsychobiology of Language, Department of Psychology, University of Milano Bicocca, Milan, MI, Italy
Combination of preoperative DTI tractography and intraoperative subcortical mapping in patient with right cerebral gliomas was used to investigate the role of long-range white matter pathways connecting parietal and frontal areas in mechanisms of spatial awareness, whose disfunction results in unilateral neglect. Preoperative segmentation of the four subcomponents of SLF by DTI tractography was obtained and transferred to neuronavigational system; during subcortical mapping, stimulation of the second branch of SLF as depicted by tractography evoked a rightward deviation on line bisection test indicating the stimulation of an area involved in spatial awareness, whose electrical inactivation was critically associated with neglect.