We present a case of a 14-year-old girl born without the left hemisphere due to prenatal left internal carotid occlusion. We combined longitudinal language and cognitive assessments with functional and structural neuroimaging data to situate the case within age-matched, typically developing children. Despite having had a delay in getting language off the ground during the preschool years, our case performed within the normal range on a variety of standardized language tests, and exceptionally well on phonology and word reading, during the elementary and middle school years. Moreover, her spatial, number, and reasoning skills also fell in the average to above-average range based on assessments during these time periods. Functional MRI data revealed activation in right fronto-temporal areas when listening to short stories, resembling the bilateral activation patterns in age-matched typically developing children. Diffusion MRI data showed significantly larger dorsal white matter association tracts (the direct and anterior segments of the arcuate fasciculus) connecting areas active during language processing in her remaining right hemisphere, compared to either hemisphere in control children. We hypothesize that these changes in functional and structural brain organization are the result of compensatory brain plasticity, manifesting in unusually large right dorsal tracts, and exceptional performance in phonology, speech repetition, and decoding. More specifically, we posit that our case's large white matter connections might have played a compensatory role by providing fast and reliable transfer of information between cortical areas for language in the right hemisphere.

中文翻译：

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一个没有左半球出生的孩子的语言发展和大脑重组。

我们介绍了一个因出生前左颈内动脉闭塞而出生而没有左半球的14岁女孩的病例。我们将纵向语言和认知评估与功能性和结构性神经影像学数据相结合，以将病例定位在与年龄匹配且通常处于发育中的儿童中。尽管在学龄前开始使用语言时有所延迟，但我们的案例在小学和初中阶段在各种标准化语言测试中均处于正常范围，并且在语音和单词阅读方面表现出色。此外，根据这些时间段内的评估，她的空间，数量和推理能力也平均下降到高于平均水平。功能性MRI数据显示，听短篇小说时，右侧额颞区激活，类似于年龄匹配的典型发育中儿童的双侧激活模式。扩散MRI数据显示，与其余正常儿童相比，在她剩余的右半球进行语言处理期间，连接着活动区域的背白质关联区（弓形筋膜的前段和前段）明显更大。我们假设这些功能性和结构性大脑组织的变化是代偿性大脑可塑性的结果，表现为异常大的右背道，以及在语音，语音重复和解码方面的出色表现。更具体地说，我们认为我们的案子'