Zdravko Kolundžić

Neuropsychological Development in Preschool Children Born With Asymmetrical Intrauterine Growth Restriction and Impact of Postnatal Head Growth

Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (P< .03) in motor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth–restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

Language development in preschool children born after asymmetrical intrauterine growth retardation

BACKGROUND After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. AIM The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. METHODS Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. RESULTS There were statistically significant differences (p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p < 0.05) in language comprehension and total expressive language. CONCLUSION Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language.

Language Recovery After Acute Intracerebral Hematoma in Temporoparietal Region

Arteriovenous malformations are the most common cause of spontaneous intracerebral hemorrhages in older children. Intracerebral hematoma can cause serious lasting neurologic, cognitive, and language deficits, or even possible death. We present the case of a 16-year-old boy who had language impairments after suffering a large hemorrhagic stroke in the left temporoparietal region. All language components, verbal and nonverbal communication, reading, and writing, were found to be affected. These impairments were expected as they are characteristic of the location of the hematoma. After a year of speech language rehabilitation, there was an almost complete recovery of language skills. Quick diagnosis and adequate therapeutic interventions are important to diminish the influence of intracerebral hemorrhage on cognitive and language functions in children.

P121 – 2636: Electroencephalographic abnormalities in children with mild traumatic brain injury

Objective Mild traumatic brain injury (MTBI) is a complex patophysiologic process affecting the brain, induced by traumatic biomechanical forces. The aim of this retrospective study is to determine the frequency and degree of electroencephalographic (EEG) abnormalities in children with MTBI without morphological brain impairment. Methods 114 participants between six months and 17.5 years of age have been admitted to Department of Surgery at General County Hospital, Požega, Croatia, between June 1st 2006 and February 1st 2011. Out of 114 participants, 74 (66%) were boys and 38 (34%) were girls. On each participant an EEG was performed within 24 hours after admission. Results EEG recording performed right after the injury was normal in 67 (58.8%) of cases and abnormal in 47 (41.2%) cases. From all abnormal recordings, EEG in 19 (16.6%) patients demonstrated diffuse dysrhythmia. Slowing was present in 13 (11.4%) EEGs (five diffusely and eight focally slowed). Paroxysmal EEG abnormalities were present in six (5.2%) patients. Focal spikes have been registrated in nine (7.8%) cases. Conclusion The study shows that children without morphological brain impairment may have EEG abnormalities directly after MTBI. It suggests that neuronal impairment occurs even in absence of observed intracranial pathology.