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Case 2


Postsurgical SMA Syndrome

Resections of SMA tumors may cause immediate postoperative motor and speech deficits, which can resolve spontaneously and completely within days to months . This condition is known as SMA syndrome (1).

The SMA is medial to Brodmann area 6 in a parasaggital location behind the posterior margin of the superior frontal
lobe (2).

Somatotopically, it is divided into three regions, an anterior one mainly involved in productive language tasks,
intermediate one related to complex movements of the upper extremities, and another posterior one that regulates movements of the lower extremities (2,3).

It is important for neurosurgeons to determine the anatomical and functional limits of an SMA resection and to identify SMA syndrome and monitor its course of recovery (1).


Oda, K., Yamaguchi, F., Enomoto, H., Higuchi, T., & Morita, A. (2018). Prediction of recovery from supplementary motor area syndrome after brain tumor surgery: preoperative diffusion tensor tractography analysis and postoperative neurological clinical course. Neurosurgical focus, 44(6), E3.

De La Pena, M. J., Robles, S. G., Rodriguez, M. R., Ocana, C. R., & De Vega, V. M. (2013). Cortical and subcortical mapping of language areas: Correlation of functional MRI and tractography in a 3 T scanner with intraoperative cortical and subcortical stimulation in patients with brain tumors located in eloquent areas. Radiología (English Edition), 55(6), 505-513.

Jenabi, M., Peck, K. K., Young, R. J., Brennan, N., & Holodny, A. I. (2014). Probabilistic fiber tracking of the language and motor white matter pathways of the supplementary motor area (SMA) in patients with brain tumors. Journal of Neuroradiology, 41(5), 342-349.