RB Anaplastic Astrocytoma Findings: During sentence completion, word generation and verb generation language tasks there is evidence of bilateral activation with left hemispheric dominance both in frontal and temporal speech areas. During the auditory response naming task there is a more symmetric appearance of language activation. Expected molar activation during motor tongue tasks. Areas of language SMA activation also identified with language tasks. Conventional imaging appearance suggestive of infiltrating astrocytoma with area of localized hemorrhages described on previous MRI. Diffusion tensor imaging demonstrates loss of color encoded fractional anisotropy involving much of the white matter tracts of the left sagittal stratum what represents tumor infiltration from edema from disruption is difficult to discern with diffusion tensor imaging. The greatest loss of color encoded fractional anisotropy is present involving the fibers of the geniculocalcarine tract, and the inferior longitudinal fasciculus.   Impression: 1. Language tasks demonstrate left hemispheric dominance.