Effect of intracranial bleeds on the neurocognitive, academic, behavioural and adaptive functioning of boys with haemophilia

Authors

  • B. S. MILES,

    1. Psychology Department, Dufferin-Peel Catholic District School Board, Mississauga, ON
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  • P. ANDERSON,

    1. Psychology Department, Children’s Hospital of Eastern Ontario, Ottawa, ON
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  • A. AGOSTINO,

    1. Psychology Department, University of Guelph, Guelph, ON, Canada
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  • M. R. GOLOMB,

    1. Division of Pediatric Neurology, Riley Hospital for Children, Indiana School of Medicine, Indianapolis, IN, USA
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  • C. ACHONU,

    1. Ontario Agency for Health Protection and Promotion
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  • V. BLANCHETTE,

    1. The Hospital for Sick Children (Feldman, Iwenofu, & McLimont from Child Health Evaluative Sciences Program, Research Institute; Feldman from Division of Rheumatology, Blanchette & Stain from Division of Hematology/Oncology, & Barnes from Program in Neuroscience and Mental Health, Research Institute), Toronto, ON
    2. University of Toronto, Toronto, ON, Canada
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  • B. M. FELDMAN,

    1. The Hospital for Sick Children (Feldman, Iwenofu, & McLimont from Child Health Evaluative Sciences Program, Research Institute; Feldman from Division of Rheumatology, Blanchette & Stain from Division of Hematology/Oncology, & Barnes from Program in Neuroscience and Mental Health, Research Institute), Toronto, ON
    2. University of Toronto, Toronto, ON, Canada
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  • M. McLIMONT,

    1. The Hospital for Sick Children (Feldman, Iwenofu, & McLimont from Child Health Evaluative Sciences Program, Research Institute; Feldman from Division of Rheumatology, Blanchette & Stain from Division of Hematology/Oncology, & Barnes from Program in Neuroscience and Mental Health, Research Institute), Toronto, ON
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  • S. REVEL-VILK,

    1. Pediatrics Hematology/Oncology Department, Hadassah Hebrew-University Hospital, Jerusalem, Israel
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  • A. STAIN,

    1. The Hospital for Sick Children (Feldman, Iwenofu, & McLimont from Child Health Evaluative Sciences Program, Research Institute; Feldman from Division of Rheumatology, Blanchette & Stain from Division of Hematology/Oncology, & Barnes from Program in Neuroscience and Mental Health, Research Institute), Toronto, ON
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  • M. A. BARNES

    1. The Hospital for Sick Children (Feldman, Iwenofu, & McLimont from Child Health Evaluative Sciences Program, Research Institute; Feldman from Division of Rheumatology, Blanchette & Stain from Division of Hematology/Oncology, & Barnes from Program in Neuroscience and Mental Health, Research Institute), Toronto, ON
    2. Department of Pediatrics, University of Texas-Houston Health Science Center, Houston, Tx, USA
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Marcia A. Barnes, PhD, Children’s Learning Institute, University of Texas-Houston Health Science Center, 7000 Fannin, Suite 2401, Houston, TX 77030, USA.
Tel.: +1 713 500 3826; fax: +1 713 500 3878;
e-mail: Marcia.barnes@uth.tmc.edu

Abstract

Summary.  Brain insults are a risk factor for neuropsychological and academic deficits across several paediatric conditions. However, little is known about the specific effects of intracranial haemorrhage (ICH) in boys with haemophilia. The study compared neurocognitive, academic and socio-emotional/behavioural outcomes of boys with haemophilia with and without a history of ICH. Of 172 consecutive patients seen at a Pediatric Comprehensive Care Hemophila Centre, 18 had a history of ICH. Sixteen boys between the ages of 3 and 17 years were available for study and were matched to controls with haemophilia of the same age and disease severity and on the basis of maternal education. Groups were compared on neuropsychological and academic outcomes. Attention, socio-emotional function and executive skills were compared using data from parent questionnaires. Differences were found in intellectual function, visual-spatial skill, fine motor dexterity and particularly language-related skills, including vocabulary, word reading and applied math problem solving. Despite these group differences, outcomes were within the average range for most boys with ICH. No group differences were found in behavioural and socio-emotional functioning. Although ICH in haemophilia is not benign, it was not associated with significant cognitive and academic consequences for most boys. Early neuropsychological assessment may be indicated when there is a history of ICH. Investigation of age at ICH and quantitative measures of brain in relation to neurocognitive outcomes in larger groups of boys with ICH would be useful.

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