Acquired Amnesia in Childhood: A Single Case Study C. L.

1. Acquired Amnesia in Childhood: A Single Case StudyC. L. Nicole E. Iannone

2. Who is it? • C. L. • 8-year old girl

3. What Went Wrong? • Surgical removal of a brain tumor from the left cerebral ventricle at the age of 4. • Healthy until 3 years, 9 months, difficulty with balancing and walking. • Brain exam identified a tumor in the left lateral and third ventricles with abnormal accumulation of cerebrospinal fluid in the ventricles. • Signs of elevated blood pressure in the brain. • 9 days after exam underwent surgical removal of tumor • 14 months after the tumor’s removal, a new MRI showed a lesion to the head of the left caudate nucleus, which was surgically removed; assumed to be tissue destruction due to radiation.

4. Nature of the Damage

5. Nature of the Damage • Diffuse damage • Level of damage between tiny and massive • An area of cortical-subcortical damage at the level of the caudal portion of the left frontal lobe. • At the cortical area, the superior gyrus and cingulate gyrus were damaged. • At the subcortical leve, the corpus callosum, white matter surrounding the front of the left lateral ventricle, the caudate nucleus, the thalamus, the superior colliculus, and the fornix were damaged. • Because of the enlargement of the left ventricle, the left hippocampus slipped down in relation to the contralateral hippocampus, with consensual twisting of the left fornix.

6. Memory • Results from testing: • Could not recover recent verbal data from episodic long-term memory. • Performed well on short-term verbal tests. • Problems with episodic visual-spatial memory: did not have any memory of a visual sequence after a 5 minute delay. • Can read and write but has some difficulty.

7. Memory • Anterograde Amnesic Syndrome: Normal short-term memory but poor explicit long-term memory • Trouble remembering day-to-day events and information • Main problem was inability to consolidate new episodic memory traces in the episodic memory system • Verbal abilities equivalent to her chronological age

8. What We Can Learn • Some case studies showed that semantic abilities are dependent on the workings of episodic memory (Squire & Zola, 1998). • The case of C. L. supports a theory of at least partially different routes to memory for autobiographical and factual information. • Adds to literature supporting a theory that children who cannot store episodic information in memory can store semantic memory

9. What We Can Learn • Theory is hippocampal functioning is necessary for episodic functioning • Perirhinal cortex might be responsible for semantic memory • Damage in the left hippocampus and a sectioning of the fornix disconnecting the mesial temporal structures from the diencephalic nuclei likely responsible for the episodic memory deficit

10. Outlook • No specific therapies being attempted • After 4 years C. L. could increase her factual knowledge and revealed a lexical-semantic repertoire similar to children of the same age

11. Questions Still to Be Answered • It remains unclear whether or not C. L. will ever be able to retain autobiographical memory. • Is this situation different for children than it is for adults?