Background Functional MRI has enabled us to map the anatomical location of functional areas of brain including language centers and thus provides useful insights in preoperative planning and assessment for neurosurgeons. In recent years, fMRI has also provided evidence for neuroplasticity which implies that brain pathways have an ability to reorganize in response to any injury. Case presentation We present a case of a 27-year-old male, postoperative case of left frontotemporal glioma (WHO grade II) with residual tumor in inferior frontal, temporal and insular lobe in whom functional magnetic resonance imaging was carried out to elicit language centers. fMRI revealed activation of Wernicke’s area in left cerebral hemisphere in the right-handed patient, while Broca’s area was activated in right cerebral hemisphere, thus eliciting the translocation of Broca’s area in response to low-grade glioma. Conclusions This case provided an example of the ability of brain to reorganize pathways in response to injury or insult. The routine use of preoperative fMRI in such cases will help in better planning and lead to an improved postoperative outcome.

Background Growing skull fracture or leptomeningeal cyst is an uncommon occurrence after severe head trauma in childhood. It is mostly observed in infants and children less than 3 years of age. Another uncommon complication of head trauma is development of porencephalic cyst. Case presentation We present an unusual case of post-traumatic type III leptomeningeal cyst in a 9-month-old infant with history of head trauma 3 months ago. CT and MR imaging revealed widening of bony defect compared to previous imaging, and herniation of porencephalic cyst through the defect, leading to formation of a large cystic swelling in scalp. The 3 month delay in evaluation of the scalp swelling was due to lack of patient education after trauma, and no subsequent follow-up. Conclusions Knowledge about etiopathogenesis and risk factors of leptomeningeal cyst development after head trauma ensures that close follow-up is done in such cases for early detection and management of growing skull fracture.

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