The role of language in communication plays a crucial role in human development and
function. In patients who have a surgical lesion at the functional language areas,
surgery should be intricately planned to avoid incurring further morbidity. This normally
requires extensive functional and anatomical mappings of the brain to identify regions
that are involved in language processing and production. In our case report, regions
of the brain that are important for language functions were studied before surgery
by employing (a) extraoperative methods such as functional magnetic resonance imaging,
transmagnetic stimulation, and magnetoencephalography; (b) during the surgery by utilizing
intraoperative awake surgical methods such as an intraoperative electrical stimulation;
and (c) a two-stage surgery, in which electrical stimulation and first mapping are
made thoroughly in the ward before second remapping during surgery. The extraoperative
methods before surgery can guide the neurosurgeon to localize the functional language
regions and tracts preoperatively. This will be confirmed using single-stage intraoperative
electrical brain stimulation during surgery or a two-stage electrical brain stimulation
before and during surgery. Here, we describe two cases in whom one has a superficial
lesion and another a deep-seated lesion at language-related regions, in which language
mapping was done to preserve its function. Additional review on the neuroanatomy of
language regions, language network, and its impairment was also described.
Key-words:
Awake surgery - brain mapping - brain network - language mapping
