A 38-year-old right-handed male presented with left glioblastoma, suffering from weakness in his right upper and lower extremities. MRI examination revealed an intra-axial tumor in the left temporal-parietal region. His language function was normal. The FA map showed decreased intralesional FA value, indicating the infiltration and destruction of WM tracts. The color-coded map showed complete disruption of the WM tracts of inferior fronto-occipital fasciculus (IFO) fibers. 3-D fiber tractography showed the intact left corticospinal tract (CST) in close relation to the lesion. The left CST was shown to be compressed and deviated medially by the mass lesion. The left arcuate fasciculus (AF) was seen away from the lesion, and unaffected by the same. Normal intact left-sided CST, IFO and AF tracts are shown for comparison. The tumor was resected maximally, avoiding the CST and AF, and was followed by chemoradiation (Figure ).
A 24-year-old male presented with right frontal-parietal glioblastoma. The FA and color-coded maps showed decreased FA value and destruction of white matter fibers. 3D tractography was initiated from the brain stem for CST. The right CST passing through the periphery of the lesion was compressed and deviated anteromedially by the lesion. The AF was compressed and deviated superiorly by the lesion, and was close to the tumor margin (Figure ).