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Four groups of patients with intrinsic cerebral neoplasms were compared to determine the differential effect of neoplasm (rapidly vs. slowly growing) and lateralization of damage (right vs. left hemisphere) upon neuropsychological functioning. No prior study has had enough subjects with neoplastic lesions to permit this kind of investigation. The group with rapidly growing neoplasms consistently had greater neuropsychological impairment. Lateralization of cerebral damage was found to have a differential effect on neuropsychological functions. Results indicate that neuropathological and lateralization characteristics of neoplastic lesions (and probably of cerebral lesions in general) are important variables in understanding the behavioral correlates of cerebral damage.

The present investigation was designed to determine the effect of cerebrovascular lesions upon general neuropsychological function. The performances of 60 patients with lateralized or diffuse cerebrovascular lesions were compared to 20 controls on cognitive and intellectual measures. Multivariate analyses indicated markedly poorer performances by the cerebrovascular groups on measures of generalized cerebral function, and no differences on such measures were found between the left- and right-damaged groups. The lateralized CVD groups demonstrated a differential tendency towards lower performances on VIQ for the left group and on PIQ for the right group. The results indicate significant neuropsychological impairment which extends beyond the expected lateralized dysfunctions, or selected deficits, associated with the damaged hemisphere. These findings indicate the importance of evaluating generalized as well as specific cognitive functions in clinical assessment of cerebrovascular lesions.

Forensic Neuropsychology is a new and rapidly evolving subspecialty of clinical neuropsychology that applies neuropsychological principles and practices to matters that pertain to legal decision-making. Forensic neuropsychologists provide the trier of fact with specialized information regarding brain-behavior relationships. The primary responsibility of the forensic neuropsychologist is to provide information based on scientifically-validated neuropsychological principles and clinical methodology that is pertinent to the Forensic Question at hand-which is not just whether the patient has dysfunction, but whether the dysfunction results from the event under consideration. To best answer the Forensic Question, the neuropsychologist must use a methodology that has been scientifically-validated on brain-impaired individuals, and can distinguish various brain conditions from each other as well as from normal variation. The methodology must be able to determine whether any dysfunction found is, in fact, the result of a neurological condition as opposed to non-neurological, psychological, or even factitious disorders. This paper discusses neuropsychological methodology in the context of forensic application and the requirements of the legal process and illustrates these issues with case examples.

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