CASE HISTORY – January 2009

Reorganization of language function following perinatal stroke: a case study


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The present article focuses on the clinical case of a 9-year-old child to introduce the functional reorganization of the brain after perinatal stroke in the left hemisphere. Clinically, the child had right-sided hemiparesis and treatable focal epileptic seizures. The child had no speech deficit or other cognitive disorders. Magnetic resonance imaging (MRI) revealed atrophy of the left hemisphere and porencephaly in the fronto-temporoparietal region as the consequences of perinatal stroke. Functional MRI was performed in junction with sensory-motor activation tests. Two paradigms were used for brain activation: a noun-verb task and a task of semantic comprehension. The fMRI data were statistically analysed applying the software SPM8. Both speech centres localized in the right hemisphere, yet no speech defect had been diagnosed earlier. The study revealed cortical reorganization of language function following perinatal stroke.