A venous malformation accompanying focal cortical dysplasia resulting in a reorganization of language-eloquent areas

Language functions are likely to become reorganized in patients with a congenital anomaly in the left hemisphere, especially if the lesion affects the classical Broca's or Wernicke's language areas. We describe a patient who presented with a venous malformation accompanying focal cortical dysplasias in the left frontal region. The epileptogenic zone (EZ) was localized in Broca's area, and the motor speech area was identified in the ipsilateral posterior part of the superior temporal gyrus by electrocortical stimulation. We completely resected the EZ in Broca's area. The patient was seizure-free with no post-surgical neurological deficits at last follow-up. The result of this study may help to extend the use of epilepsy surgery within eloquent areas, and also partly explain the plasticity and reshaping of the language processing functional areas associated with a congenital lesion and chronic epilepsy. (C) 2010 Elsevier Ltd. All rights reserved.