Editorial: standard neuropsychological assessments in neurosurgery
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Neuropsychological Assessment
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The authors analyzed the results of neuropsychological examinations in 30 cases in which a single intracranial aneurysm had been excluded from circulation. The neuropsychological assessment of the higher mental functions was carried out using a set of tests of A. R. Luria in all cases and repeated thrice, comparing the results with those of neurological examination and EEG. The condition of the patients was evaluated using a three-grade scale. In the group of cases with aneurysms of the anterior communicating artery a divergence was observed between the results of neuropsychological examination and neurological examination. The patients achieved not infrequently, very good and good Grades in neurological examination and unsatisfactory in neuropsychological examination and unsatisfactory in neuropsychological examination. A similar divergence was observed also when the aneurysm was situated in other cerebral arteries. On the other hand, considerable similarities were found between the neuropsychological assessment and the result of EEG (with regard to the location, of disturbances and their intensity). Neuropsychological examination made possible detection and determination of the dynamic development of defects in the functions of higher psychic activities inaccessible for routine neurological examination, but having a very important effect on the everyday functions of the patient.
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This chapter provides guidelines to help psychologists make decisions about when to refer a child or adolescent neuropsychological assessment, for neurological examination, or other neurodiagnostic testing (e.g., CT scan or MRI). Children and adolescents often need neurological, neuroradiological, and/or neuropsychological assessments. Although not every child seen for cognitive, academic, psychiatric, or behavioral problems requires further assessment apart from traditional psychoeducational evaluations, some disorders do need further attention by specialists to investigate the child’s neurological or neuropsychological status.
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Neurotoxicity
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Chapter 17 discusses adult neuropsychological assessment, including fundamental assumptions, uses, and approach to clinical neuropsychological assessment, the clinical method (including obtaining patient history, behavioral observation, domains of neuropsychological function and diagnostic formulation).
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The purpose of this chapter is to introduce neuropsychology and neuropsychological assessment of children, with a focus on neurologically impaired children. Thus, we begin with a brief historical overview of the concept of neurological impairment and neuropsychological assessment in children, and delineate the role of a neuropsychologist in diagnosis and assessment. Next, we offer a set of conceptual principles for neuropsychological assessment, review its related methods and procedures, and describe the differences in purpose and scope of evaluations conducted by school psychologists, clinical child psychologists, and neuropsychologists. After that, we review the neuropsychological outcomes associated with several of the more common childhood neurological disorders. Finally, we examine a neuropsychological management approach and related intervention techniques used to help neurologically impaired children adapt to and compensate for their difficulties.
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To investigate the clinical, neuropsychological and imaging manifestations of Sjögren's syndrome (SS), a chronic auto-immune disease with peripheral and central nervous system (CNS) involvement.Fourteen female patients suffering from confirmed SS underwent within 2 weeks: neurological examination, immunological staging, brain MRI, brain 99m Tc-HMPAO SPECT, psychological evaluation and in-depth neuropsychological testing.All patients showed neuropsychological abnormalities. The cognitive symptoms were of the same type in all patients, mostly frontal lobe syndrome and memory problems. The neuropsychological involvement was not associated with other kinds of CNS involvement or MRI abnormalities, but accurately reflected HMPAO imaging results.The results of this study indicate that cognitive evaluation is the most sensitive clinical test to diagnose CNS involvement in patients with SS, and that CNS involvement in SS seems to be more frequent when systematically assessed by neuropsychological tests.
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This study explores the use of the Progressive Figures Test as an instrument for broad initial screening of children in the 6- through 8-year age range with respect to the possible need for more definitive neuropsychological evaluation. Considering earlier results obtained in comparison of brain-damaged and control children [Clinical Neuropsychology: Current Applications, Hemisphere Publishing Corp., Washington, DC, 1974, p. 53; Proceedings of the Conference on Minimal Brain Dysfunction, New York Academy of Sciences, New York, 1973, p. 65], the Progressive Figures Test seemed potentially useful as a first step in determining whether a comprehensive neuropsychological evaluation is indicated. In this investigation, three groups were studied: (1) children with definitive evidence of brain damage or disease who, when compared with normal controls, help to establish the limits of neuropsychological functioning, (2) a group of children who had normal neurological examinations but also had academic problems of significant concern to both parents and teachers, and (3) a normal control group. Statistically significant differences were present in comparing each pair of groups, with the brain-damaged children performing most poorly and the controls performing best. Score distributions for the three groups make it possible to identify a score-range that represented a borderline or “gray” area and to suggest a cutting score that identified children whose academic problems might have a neurological basis and for whom additional neuropsychological evaluation appeared to be indicated.
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