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

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

What Went Wrong? Surgical removal of a brain tumor from the left cerebral ventricle at the age of 4. 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. 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. 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. Signs of elevated blood pressure in the brain. 9 days after exam underwent surgical removal of tumor 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. 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.

Nature of the Damage

Diffuse damage Diffuse damage Level of damage between tiny and massive 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. 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 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. 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. 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.

Memory Results from testing: Results from testing: Could not recover recent verbal data from episodic long-term memory. Could not recover recent verbal data from episodic long-term memory. Performed well on short-term verbal tests. 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. 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. Can read and write but has some difficulty.

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

What We Can Learn Some case studies showed that semantic abilities are dependent on the workings of episodic memory (Squire & Zola, 1998). 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. 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 Adds to literature supporting a theory that children who cannot store episodic information in memory can store semantic memory

What We Can Learn Theory is hippocampal functioning is necessary for episodic functioning Theory is hippocampal functioning is necessary for episodic functioning Perirhinal cortex might be responsible for semantic memory 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 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

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

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