A 34-year-old right-handed female developed an episode of partial epilepsy with transient language disorder. She recovered completely after few minutes of a seizure episode. MRI showed the left insular lesion characteristic for low-grade glioma. Pre-operative DTI was done to demonstrate the relationship of a lesion to eloquent areas to allow maximum tumor resection and to avoid tumor recurrence and damage to vital areas, such as language and motor function. Axial whole brain tractography showed destruction and distortion of the left frontal fibers and the left IFO tract. Anterior part of arcuate fasciculus (AF) was seen in close relation to the anterior-superior part of the lesion. The left CST was intact, yet medially deviated (Figure ).
A 67-year-old man was admitted to our hospital with headache and weakened left limbs. Muscle strength on the left side was grade 4. Routine MRI displayed a mass lesion close to the posterior horn of the right lateral ventricle with low T1-signal intensity and high T2-signal intensity. Peritumoral edema was markedly presented and showed lower FA (0.08-0.22) compared to the contralateral whiter matter (0.40). Fibers displayed interruption distally to the right CST (fig. ) and did not significantly improve using an FA cut-off value of 0.10 for fiber-tracking. The mass was confirmed to be a metastatic tumor from a renal cell carcinoma of the right kidney after histopathological findings.