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Published on: November 19, 2012
Neurocognitive outcomes following intracerebral hemorrhage in childhood
Claire M Champigny1, Leila Kahnami1,2, Tamiko Isaacs2
1Department of Psychology, The Hospital for Sick Children, Toronto, Canada.
Insights
Children with a history of childhood intracerebral hemorrhage (ICH) often experience neurocognitive deficits. While Full Scale IQ may appear average, specific areas like verbal learning and processing speed show significant impairments, warranting clinical attention.
Area of Science:
- Pediatric Neurology
- Neuropsychology
Background:
- Intracerebral hemorrhage (ICH) in childhood can lead to neurocognitive deficits.
- This pediatric population remains understudied regarding long-term neurocognitive outcomes.
Purpose of the Study:
- To conduct a preliminary exploration of neurocognitive outcomes in children with a history of ICH.
- To identify specific neurocognitive domains affected by childhood ICH.
Main Methods:
- A neuropsychological assessment was administered to 17 pediatric patients with a history of ICH.
- Evaluated domains included perceptual reasoning, verbal reasoning, processing speed, working memory, verbal learning, verbal memory, visuomotor integration, selective attention, and executive functioning.
Main Results:
- Mean Full Scale IQ (FSIQ) was within the clinically average range but skewed toward lower scores.
- 50-60% of participants scored below average in verbal learning, verbal memory, processing speed, and visuomotor integration.
- Youth with childhood ICH may exhibit average FSIQ but show group-level skew towards lower ranges and specific domain deficits.
Conclusions:
- Children with a history of ICH may have average overall IQ but present with deficits in specific neurocognitive areas.
- Comprehensive neuropsychological assessment is crucial for understanding and managing these deficits.
- Findings inform clinical practice, including intake interviews, test battery development, and prognosis appraisal.
Abstract:
Neurocognitive deficits commonly occur following intracerebral hemorrhage (ICH) in childhood, yet this population remains understudied. The current study is a preliminary exploration of neurocognitive outcomes in this population. At the Hospital for Sick Children in Toronto, Canada, 17 patients (Mage = 14.2, SD = 4.6) with a history of childhood ICH completed a neuropsychological assessment evaluating perceptual reasoning, verbal reasoning, processing speed, working memory, verbal learning, verbal memory, visuomotor integration, selective attention, and executive functioning. Mean Full Scale IQ (FSIQ; M = 98.1, SD = 13.6) fell within the clinically average range compared to population norms, though it was skewed toward lower ranges. Furthermore, approximately 50-60% of the participants scored under the clinically average range on tests of verbal learning, verbal memory, processing speed, and visuomotor integration. Youth with childhood ICH may present with FSIQ within the average range, but as a group they skew toward lower ranges and are more likely to demonstrate deficits in distinct neurocognitive domains. Clinical evaluation of a wide range of neuropsychological skills is warranted. Clinical implications encompass informing of intake interviews, development of test batteries, and appraisal of prognosis. Findings contribute to the limited knowledge base about neurocognitive outcomes following childhood ICH.
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