Background
Pediatric neurologists and neonatologists are often asked to prognosticate about cognitive outcome after perinatal brain injury (including likely memory and learning outcomes); however, relatively little data exists upon which accurate predictions can be made. Further, while the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children.
Methods
We measured the volume of the hippocampus in 27 children with perinatal stroke and 19 controls, and measured their performance on standardized verbal and non-verbal memory tests.
Results
(i) As a group, children with perinatal stroke had smaller left and right hippocampi compared to controls. (ii) Individually, children with perinatal stroke demonstrated one of 3 findings: no hippocampal loss, unilateral hippocampal loss, or bilateral hippocampal volume loss compared to controls. (iii) Hippocampal volume inversely correlated with memory test performance in the perinatal stroke group, with smaller left and right hippocampal volumes related to poorer verbal and non-verbal memory test performance, respectively. (iv) Seizures played a significant role in determining the presence of memory deficit and extent of hippocampal volume reduction in patients with perinatal stroke.
Conclusions
These findings support the view that, in the developing brain, the left and right hippocampi preferentially support verbal and non-verbal memory respectively, a consistent finding in the adult literature but a subject of debate in the pediatric literature. This is the first work to report that children with focal brain injury incurred from perinatal stroke have volume reduction in the hippocampus and impairments in certain aspects of declarative memory.