{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:43:53Z","timestamp":1771051433636,"version":"3.50.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,5,5]]},"abstract":"\n BACKGROUND<\/jats:title>\n Signed language integrates complex sensorimotor processes involving visual and motor networks. The contribution of language regions such as Broca\u2019s and Wernicke\u2019s areas during signing is not well established. Here, the authors report the case of a 45-year-old right-handed male with congenital deafness, who communicates using American Sign Language (ASL) and Signed English, presenting with focal seizures. Imaging showed a diffuse infiltrative glioma in the right cerebral hemisphere.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Remarkably, preoperative functional MRI language activations were bihemispheric and overlapped for both traditional language paradigms and sign paradigms, suggesting that the same cortical regions of the brain are used for language processing in this patient. This case is unique because it is the first reported awake craniotomy performed in a deaf patient with a right hemispheric glioma. The authors also found that direct cortical stimulation of the right premotor cortex (Exner\u2019s area) resulted in interruption of signing, which has not been previously reported in the literature in a deaf patient.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Prior to surgery for brain lesions in deaf patients, careful preoperative assessment and intraoperative testing (including the presence of an experienced ASL sign interpreter) is required to understand the distribution of language processing within the brain and to minimize postoperative morbidity.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2597<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2597","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T20:14:44Z","timestamp":1746476084000},"source":"Crossref","is-referenced-by-count":2,"title":["Language mapping during awake brain surgery in a deaf patient with a brain tumor: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Ene","family":"Chibawanye I.","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle","family":"Noll","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7037-4932","authenticated-orcid":true,"given":"Katherine","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho-Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Tummala","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Akron General, Akron, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ferson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick F.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-1233","authenticated-orcid":true,"given":"Vinodh A.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"23","key":"bib1","series-title":"JAMA","first-page":"2535","article-title":"Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial","volume":"314","author":"Stupp","year":"2015","unstructured":"Stupp RTaillibert SKanner AAMaintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314(23):2535-2543."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"325","article-title":"Awake craniotomy to maximize glioma resection: methods and technical nuances over a 27-year period","volume":"123","author":"Hervey-Jumper","year":"2015","unstructured":"Hervey-Jumper SLLi JLau DAwake craniotomy to maximize glioma resection: methods and technical nuances over a 27-year period. J Neurosurg. 2015;123(2):325-339."},{"issue":"3","key":"bib3","series-title":"PLoS One","first-page":"e0194143","article-title":"Diagnosis of aphasia in stroke populations: a systematic review of language tests","volume":"13","author":"Rohde","year":"2018","unstructured":"Rohde AWorrall LGodecke EO\u2019Halloran RFarrell AMassey M.Diagnosis of aphasia in stroke populations: a systematic review of language tests. PLoS One. 2018;13(3):e0194143."},{"key":"bib4","series-title":"World Neurosurg","first-page":"260","article-title":"Awake craniotomy with cortical and subcortical speech mapping for supramarginal cavernoma resection","volume":"141","author":"Domingo","year":"2020","unstructured":"Domingo RAVivas-Buitrago TSabsevitz DSMiddlebrooks EHQuinones-Hinojosa A.Awake craniotomy with cortical and subcortical speech mapping for supramarginal cavernoma resection. World Neurosurg. 2020;141:260."},{"key":"bib5","series-title":"Concise American Sign Language Dictionary","author":"Costello","year":"2002","unstructured":"Costello E.Concise American Sign Language Dictionary. Bantam Books; 2002."},{"issue":"12","key":"bib6","series-title":"Brain","first-page":"2512","article-title":"Handedness and hemispheric language dominance in healthy humans","volume":"123","author":"Knecht","year":"2000","unstructured":"Knecht SDr\u00e4ger BDeppe MHandedness and hemispheric language dominance in healthy humans. Brain. 2000;123(12):2512-2518."},{"key":"bib7","series-title":"Neuropsychologia","first-page":"179","article-title":"An fMRI study of perception and action in deaf signers","volume":"82","author":"Okada","year":"2016","unstructured":"Okada KRogalsky CO\u2019Grady LAn fMRI study of perception and action in deaf signers. Neuropsychologia. 2016;82:179-188."},{"issue":"1","key":"bib8","series-title":"Nat Neurosci","first-page":"76","article-title":"A critical period for right hemisphere recruitment in American sign language processing","volume":"5","author":"Newman","year":"2002","unstructured":"Newman AJBavelier DCorina DJezzard PNeville HJ.A critical period for right hemisphere recruitment in American sign language processing. 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Ann Neurol. 2009;66(4):537-545."},{"issue":"1","key":"bib22","series-title":"Commun Biol","first-page":"443","article-title":"Graphomotor memory in Exner\u2019s area enhances word learning in the blind","volume":"4","author":"Mizuochi-Endo","year":"2021","unstructured":"Mizuochi-Endo TItou KMakuuchi MKato BIkeda KNakamura K.Graphomotor memory in Exner\u2019s area enhances word learning in the blind. Commun Biol. 2021;4(1):443."},{"issue":"23","key":"bib1","series-title":"JAMA","first-page":"2535","article-title":"Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial","volume":"314","author":"Stupp","year":"2015","unstructured":"Stupp RTaillibert SKanner AAMaintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314(23):2535-2543."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"325","article-title":"Awake craniotomy to maximize glioma resection: methods and technical nuances over a 27-year period","volume":"123","author":"Hervey-Jumper","year":"2015","unstructured":"Hervey-Jumper SLLi JLau DAwake craniotomy to maximize glioma resection: methods and technical nuances over a 27-year period. J Neurosurg. 2015;123(2):325-339."},{"issue":"3","key":"bib3","series-title":"PLoS One","first-page":"e0194143","article-title":"Diagnosis of aphasia in stroke populations: a systematic review of language tests","volume":"13","author":"Rohde","year":"2018","unstructured":"Rohde AWorrall LGodecke EO\u2019Halloran RFarrell AMassey M.Diagnosis of aphasia in stroke populations: a systematic review of language tests. PLoS One. 2018;13(3):e0194143."},{"key":"bib4","series-title":"World Neurosurg","first-page":"260","article-title":"Awake craniotomy with cortical and subcortical speech mapping for supramarginal cavernoma resection","volume":"141","author":"Domingo","year":"2020","unstructured":"Domingo RAVivas-Buitrago TSabsevitz DSMiddlebrooks EHQuinones-Hinojosa A.Awake craniotomy with cortical and subcortical speech mapping for supramarginal cavernoma resection. World Neurosurg. 2020;141:260."},{"key":"bib5","series-title":"Concise American Sign Language Dictionary","author":"Costello","year":"2002","unstructured":"Costello E.Concise American Sign Language Dictionary. Bantam Books; 2002."},{"issue":"12","key":"bib6","series-title":"Brain","first-page":"2512","article-title":"Handedness and hemispheric language dominance in healthy humans","volume":"123","author":"Knecht","year":"2000","unstructured":"Knecht SDr\u00e4ger BDeppe MHandedness and hemispheric language dominance in healthy humans. Brain. 2000;123(12):2512-2518."},{"key":"bib7","series-title":"Neuropsychologia","first-page":"179","article-title":"An fMRI study of perception and action in deaf signers","volume":"82","author":"Okada","year":"2016","unstructured":"Okada KRogalsky CO\u2019Grady LAn fMRI study of perception and action in deaf signers. Neuropsychologia. 2016;82:179-188."},{"issue":"1","key":"bib8","series-title":"Nat Neurosci","first-page":"76","article-title":"A critical period for right hemisphere recruitment in American sign language processing","volume":"5","author":"Newman","year":"2002","unstructured":"Newman AJBavelier DCorina DJezzard PNeville HJ.A critical period for right hemisphere recruitment in American sign language processing. 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Hum Brain Mapp. 2021;42(3):699-712."},{"key":"bib11","series-title":"World Neurosurg","first-page":"883.e1","article-title":"Successful insular glioma removal in a deaf signer patient during an awake craniotomy procedure","volume":"98","author":"Metellus","year":"2017","unstructured":"Metellus PBoussen SGuye MTrebuchon A.Successful insular glioma removal in a deaf signer patient during an awake craniotomy procedure. World Neurosurg. 2017;98:883.e1-883.e5."},{"key":"bib12","series-title":"Neural Plast","first-page":"1","article-title":"The cross-modal effects of sensory deprivation on spatial and temporal processes in vision and audition: a systematic review on behavioral and neuroimaging research since 2000","volume":"2019","author":"Bell","year":"2019","unstructured":"Bell LWagels LNeuschaefer-Rube CFels JGur REKonrad K.The cross-modal effects of sensory deprivation on spatial and temporal processes in vision and audition: a systematic review on behavioral and neuroimaging research since 2000. Neural Plast. 2019;2019:1-21."},{"key":"bib13","series-title":"Neural Plast","first-page":"1","article-title":"Functional reorganizations of brain network in prelingually deaf adolescents","volume":"2016","author":"Li","year":"2016","unstructured":"Li WLi JWang JFunctional reorganizations of brain network in prelingually deaf adolescents. Neural Plast. 2016;2016:1-10."},{"key":"bib14","series-title":"Neural Plast","article-title":"Language and sensory neural plasticity in the superior temporal cortex of the deaf","volume":"2018","author":"Que","year":"2018","unstructured":"Que MJiang XYi CLanguage and sensory neural plasticity in the superior temporal cortex of the deaf. Neural Plast. 2018;2018:9456891."},{"key":"bib15","series-title":"World Neurosurg","first-page":"629","article-title":"Awake craniotomy for a left pan-hippocampal diffuse low-grade glioma in a deaf and mute patient using sign language","volume":"134","author":"Chen","year":"2020","unstructured":"Chen PAChen YCWei KCChen KT.Awake craniotomy for a left pan-hippocampal diffuse low-grade glioma in a deaf and mute patient using sign language. 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Acta Neurochir (Wien). 2024;166(1):260."},{"issue":"6","key":"bib17","series-title":"Acta Neurochir (Wien)","first-page":"1665","article-title":"Subcortical language localization using sign language and awake craniotomy for dominant posterior temporal glioma resection in a hearing-impaired patient","volume":"165","author":"Lau","year":"2023","unstructured":"Lau RMalhotra AKMcAndrews MPKongkham P.Subcortical language localization using sign language and awake craniotomy for dominant posterior temporal glioma resection in a hearing-impaired patient. Acta Neurochir (Wien). 2023;165(6):1665-1669."},{"key":"bib18","series-title":"Surg Neurol Int","first-page":"167","article-title":"Awake surgery for a deaf patient using sign language: a case report","volume":"15","author":"Yamamoto","year":"2024","unstructured":"Yamamoto AKijima NUtsugi RAwake surgery for a deaf patient using sign language: a case report. 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