Background
Functional MRI (fMRI) based on language tasks has been used in pre-surgical language mapping in patients with lesions in or near putative language areas. However, if the patients have difficulty performing the tasks due to neurological deficits, it leads to unreliable or non-interpretable results. In this study, we investigate the feasibility of using a movie-watching fMRI for language mapping.
Methods
A 7-min movie clip with contrasting speech and non-speech segments was shown to 22 right-handed healthy subjects. Based on all subjects' language functional regions-of-interest, six language response areas were defined, within which a language response model (LRM) was derived by extracting the main temporal activation profile. Using a leave-one-out procedure, individuals' language areas were identified as the areas that expressed highly correlated temporal responses with the LRM derived from an independent group of subjects.
Results
Compared with an antonym generation task-based fMRI, the movie-watching fMRI generated language maps with more localized activations in the left frontal language area, larger activations in the left temporoparietal language area, and significant activations in their right-hemisphere homologues. Results of two brain tumor patients' movie-watching fMRI using the LRM derived from the healthy subjects indicated its ability to map putative language areas; while their task-based fMRI maps were less robust and noisier.
Conclusions
These results suggest that it is feasible to use this novel “task-free” paradigm as a complementary tool for fMRI language mapping when patients cannot perform the tasks. Its deployment in more neurosurgical patients and validation against gold-standard techniques need further investigation.
The anterior iliac crest is the harvest site preferred by many surgeons because of the quantity and quality of bone obtainable and the simplicity of harvesting techniques. Avulsion fracture of the iliac crest following bone grafting is an extremely rare occurrence. We present a case report of avulsion fracture of the anterior iliac crest following bone graft harvesting for anterior cervical fusion in a 63-year-old man. Non-operative treatment was the method of our treatment in the patient. By means of the presented case, iliac crest bone grafting techniques, risk factors of avulsion fracture, and treatment options were reviewed.
KeywOrds: Bone transplantation, Cervical vertebrae, Iliac crest, Postoperative complications, Spinal fusion
ÖZAnterior iliak kıyı, nitelik ve nicelik olarak iyi bir kemik ve kolay alınabilir olması nedeniyle greft yeri olarak çoğu cerrah tarafından tercih edilmektedir. Spinal füzyon icin kemik alınmasını takiben iliak kıyı kırığı gelişmesi oldukça nadir gelişen bir durumdur. Anterior servikal füzyon için kemik greft alınmasını takiben anterior iliak kıyı kopma kırığı gelişen 63 yaşında bir erkek hasta sunulmuştur. Hastadaki tedavi metodumuz ameliyat dışı tedavi oldu. Sunulan olgu aracılığıyla iliak kıyıdan greft alma teknikleri, kırık için risk faktörleri ve tedavi seçenekleri gözden geçirildi.
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