Based on its character, this tract was named the Broca-LSFG pathway. These findings suggest a close relationship between this pathway and language organization. The structural anatomy of the Broca-LSFG pathway may explain speech disturbances induced by LSFG stimulation that are sometimes observed during intraoperative language mapping.
The frequency and anatomical features of the occipital sinus (OS) were analyzed in this study by contrast-enhanced magnetic resonance venography (MRV) with enhanced fast gradient echo three-dimensional (EFGRE3D) and we discuss the clinical usefulness of this method. The study included 555 patients who underwent contrast-enhanced MRV with EFGRE3D, and maximum intensity projection (MIP), multiplanar reformation (MPR) and multiprojection volume reconstruction (MPVR) images were obtained for the regions of interest. The frequency, size and communication of the OS with other vessels were assessed. The OS was identified in 209 of the 555 patients (37.7%). There were no statistically significant sex-related differences. The OS was observed less frequently in subjects younger than 50 years. Cranially and/or caudally, some OS were separated and communicated with multiple vessels. In five patients, the straight sinus (StS) communicated directly with the OS and not with the other sinuses; in two patients, the StS communicated with veins other than the OS only via small anastomotic veins. Many morphological differences in the OS can be seen. In addition, some OS function as the main drainage route of the intracranial veins instead of the transverse sinus or sigmoid sinus. In addition to MIP, detailed examination by MPR and MPVR is required for the preoperative evaluation of posterior cranial fossa lesions.
Metastasis of systemic cancer to intracranial tumors is a rare event. The authors report a case of 49-year-old woman with such occurrence, whose breast cancer metastasized to a preexisting parasagittal meningioma at a postoperative interval of 1.5 years. She was admitted to our hospital because of progressive right hemiparesis. Magnetic resonance imaging revealed newly emerged perifocal edema and inhomogeneous contrast enhancement of the meningioma. High choline/creatine ratio and lactate/lipid peak on proton magnetic resonance spectroscopy suggested malignancy. She underwent a tumor resection, and pathologic examination revealed intratumoral metastasis of breast cancer in a transitional meningioma. Immunoreactivity of E-cadherin was detected in both meningioma and breast cancer cells. It is suggested that abrupt appearance of symptoms, inhomogeneous enhancement, and perifocal edema of meningioma is a sign of intratumoral metastasis from systemic cancers.
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