Evidence of cognitive visual problems in children with hydrocephalus: a structured clinical history-taking strategy

Abstract

Damage to the occipital cortex in children can result in many complex disorders of cognitive visual function. A series of clinical questions, developed from the specific problems of a cohort of children with cortical visual impairment, was asked of the parents of 200 children with no history of cerebral pathology, aged 5 to 12 years. One hundred and ninety-two parents gave reliable consistent responses. The results show a progressive improvement in performance with age, culminating in few 11- and 12-year olds having frequent problems, apart from 8% having frequent difficulty with orientation in new surroundings and 2% having problems with simultaneous perception tasks. The parents of 52 children (aged 5 to 17 years) with shunted hydrocephalus were then asked the same set of questions. Evidence of cognitive visual problems was identified in 27 of these children of whom 16 manifested multiple difficulties. The disabilities identified by our study comprised problems with: shape recognition, simultaneous perception, perception of movement, colour perception, orientation, object recognition, and face recognition. The range, nature, and combinations of these disorders are presented in this paper.

Behavioural problems and autism in children with hydrocephalus

“…The loss of periventricular white matter also causes visual perception problems as in children born preterm with periventricular leukomalacia (PVL) (Jacobson et al, 1996) and in children with congenital hemiplegia (Carlsson et al, 1994). Non-verbal problems manifest themselves as poor performance on visual recognition/discrimination tasks, eye-hand co-ordination, visuo-construction, visuo-orientation and recognition of faces (prosopagnosia) (Houliston et al, 1999). The enlargement of the ventricles is likely to cause damage to the optic nerves and oculomotor pathways, which also helps to explain the children's visual impairments (Houliston et al, 1999).…”

“…Non-verbal problems manifest themselves as poor performance on visual recognition/discrimination tasks, eye-hand co-ordination, visuo-construction, visuo-orientation and recognition of faces (prosopagnosia) (Houliston et al, 1999). The enlargement of the ventricles is likely to cause damage to the optic nerves and oculomotor pathways, which also helps to explain the children's visual impairments (Houliston et al, 1999). In children with MMC and hydrocephalus, it was previously hypothesised that upper-limb dysfunction could help to explain their eye-hand co-ordination and visuo-constructional difficulties (Wills et al, 1990).…”

Cognitive vision, its disorders and differential diagnosis in adults and children: knowing where and what things are

“…Difficulties recognising shape and form have also been described. 98,100 Such children can have problems with geometry but cope well with other aspects of maths. They may also have reading difficulties related to letter and word recognition.…”

Association of binocular lower visual field impairment, impaired simultaneous perception, disordered visually guided motion and inaccurate saccades in children with cerebral visual dysfunction—a retrospective observational study

“…1,2 Over 50% of children with hydrocephalus, for example, may have significant difficulties interpreting visual input. 3 Occipital PVL is probably one of the commonest causes of such visual impairment, which is frequently associated with peripheral lower visual field deficits. 4 The optic radiations that subserve the lower visual field lie above and adjacent to the occipital horns of the lateral ventricles where they are susceptible to damage by PVL.…”