When a parent suffers ABI: Investigation of emotional distress in children

PRIMARY OBJECTIVE

To investigate the type of emotional and behavioural impact that having a parent with a severe acquired brain injury (ABI) has on children during the first period of adjustment.

METHODS AND PROCEDURE

The study involved 25 couples in which one of the spouses was affected by ABI, and their 35 children (3-14 years). The children attended three sessions with a psychologist aimed at identifying their spontaneous playing and relational behaviour by means of a grid created on the basis of ICD-10 criteria. Both members of each parental couple attended a session with the psychologist, and were administered the Dyadic Adjustment Scale, the 36-item Health Survey and the Caregiver Burden Inventory.

RESULTS

63% of the children showed signs of emotional suffering, the presence of which was underestimated by their parents on the basis of the psychologist's assessments. The variables that correlated most closely with the children's psychological condition were related to the quality of their parents' relationship.

CONCLUSIONS

Our findings confirm the need for early interventions aimed at both parents and their children in order to investigate the children's emotional-affective situation, and favour an understanding of their discomfort by their parents.

The necropolis of Bolgare (Lombardy, Italy): Anthropological and paleopathological features of a Lombard population

The mediaeval necropolis of Bolgare - St. Chierico is an important site in northern Italy, located in the Bergamo Province (about 40 km East of Milan). In order to reconstruct aspects of the demographic and health status of this Lombard population, macroscopic (morphological, metric and radiographic) and microscopic analyses were performed on over 400 skeletons for the assessments of sex (cranial and pelvic morphology, metrics), age (subadults: dental and bone development; adults: mainly pubic symphysis, auricular surface of the ilium, 4th rib) and stature, for the determination of ancestry and the identification of pathologies. Results proved the sample to be heterogeneous with males, females, adults and subadults. The sample seemed to be composed of several groups, including individuals with northern or eastern (Uralic) European features and, on the other hand, individuals with central European or Mediterranean characteristics. The first may be indicative of migrations of Lombards (suggested by tall stature estimates); the second could be considered autochthonous, bearing features more typical of northern Italian populations. Among palaeopathological finds, the study showed the presence of tuberculosis, gout, DISH and degenerative pathologies particularly on the pelvis and spinal column. The population of Bolgare constitutes one of the main sources of anthropological data on Lombards in Italy.

Rehabilitation of acquired brain injuries: a multicentric prospective survey

BACKGROUND

The rehabilitation of the persons with Severe Acquired Brain Injury (ABI) is an important concern to be approached with a comprehensive program aimed to improve the recovery of patients.The efficacy of an early and intensive rehabilitation program has been shown in large number of studies. Few studies focused on the prevalence of TBI and the data are often extrapolated in indirect ways.

AIM

An analysis of the demographic characteristics of the population included in the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione- Italian Group for the Study of the severe ABI) database, type and conditions associated to the index event; the treatment administered during hospitalization; and the prognosis according to outcome measures.

DESIGN

The study was an observational prospective survey looking at management of ABI (both traumatic and non-traumatic).

SETTING

In hospital rehabilitation.

POPULATION

Patients consecutively admitted in each of the 52 GISCAR centres.

METHODS

Every centre included a consecutive cohort and recorded demographic data and index event characteristics.

RESULTS

In the study population were included 2626 subjects suffering of a severe ABI. The difference of length of stay (LOS) was significantly different with 67.5 days for traumatic patients compared to the 80 days of non traumatic ones. In the study population the probability of discharge at home is significantly greater for the traumatic condition (odds ratio 0,4587; CI 0.3671-0.5731). The overall benefit of the rehabilitative treatment was encountered in a net gain in all disability scores taken into account: LCF classes; DRS as well as GOS scores. At discharge the main destination for severe ABI patients was home (67.2%).

CONCLUSIONS

A large number of patients admitted in Italian rehabilitative facilities for a severe ABI suffered from a TBI, more often these subjects were young male victims of road accident. The majority of subjects during the rehabilitative hospitalization demonstrated a significant recovery.

CLINICAL REHABILITATION IMPACT

Considering the evidence of an early treatment benefit the delay ofthe rehabilitation program start is far from being satisfactory. The high frequency of the home discharge indicate a good compliance of national family network.

[Rehabilitative strategies in patients with subarachnoid hemorrhage]

The role of rehabilitative treatment in neurological disorders due to subarachnoid haemorrhage is described in acute, intermediate and chronic phases. A fourth phase, defined phase of diagnosis and treatment of cognitive and behavioural "cripto-deficits", is discussed. In each phase, emphasis is put on the organization of rehabilitative work which should always be the result of integrative team approach, to prevent and correct complications and to apply an holistic treatment (physical and cognitive). At present, in neurological rehabilitation, the most important requirement is no longer have the professionals (physiotherapists, speech and occupational therapists, etc.), but have a suitable environment and a good organisation of team planning and work. Neurosurgical centers is warranted. Practice guidelines should be addressed to obtain quality and continuity of management in the early diagnostic phase; intensive global medical approach should be ensured by neuroanesthesists and intensivists to achieve optimal cerebral conditions before surgical or endovascular treatment.

Traumatic brain injury in childhood: intellectual, behavioural and social outcome into adulthood

In order to obtain indicative data regarding intellectual, behavioural and social outcome into adulthood of subjects with a history of childhood head injury (CHI), twenty adults were selected who had been referred to the Neuropsychology Unit at the University of Parma at the time of a traumatic brain injury (TBI) at an age between 8 and 14 years. The level of intellectual and behavioural impairment was determined and rated by WISC and WAIS IQa and by the frequency of maladjustive behaviour. GOS score and Barthel index were used to detect the level of disability. Social adjustment and community integration were determined by the Social Adjustment Scale (SAS) and the Community Integration Questionnaire (CIQ) respectively. Results indicate that (1) subjects who suffer a severe CHI present a higher pre-injury incidence of character disturbances than the normal population and injury-related difficulties to socialize which persist long-term and add to other problems; (2) even though intellectual and functional sequelae are frequent in these children in adulthood and do not improve in their correlation to age, these do not appear to be the prevailing problems and (3) the prevailing problems seem to be social maladjustment and poor quality of life, which are still present several years post-injury and seem to be related to behavioural and psychosocial disorders in spite of an increased ADL-functioning. This has already been clearly demonstrated in the case of adulthood trauma.

Post-concussive syndrome: paraclinical signs, subjective symptoms, cognitive functions and MMPI profiles

In order to investigate the organic and psychogenic components of post-concussive syndrome (PCS), the subjective complaints, the cognitive findings and the Minnesota Multiphasic Personality Inventory (MMPI) profiles of 53 consecutive mild head injury patients (MHI) with persistent PCS were evaluated. The results seem to suggest the presence of two groups: in the first, minimal lesional signs were associated with more prolonged loss of consciousness (LC) and post-traumatic amnesia (PTA), as well as an MMPI profile not indicative of a neurotic state, whereas in the second the absence of any lesional sign was associated with shorter LC and PTA duration, as well as evidence of neurotic MMPI scores. A female prevalence was observed in the first group and a male prevalence in the other one.

A new case of retrograde amnesia with abnormal forgetting rate

The classic amnesic syndrome is characterised by a severe anterograde amnesia and a less important retrograde amnesia with sparing of the semantic component. We report the case of a patient who showed a global amnesic syndrome following a mild head injury. Initially, amnesia was both anterograde and retrograde, and also involved semantic knowledge. Two years later the picture had changed remarkably. The retrograde deficit for autobiographical events was still total, while semantic memory had recovered to a large extent. Learning had also greatly improved, but only if assessed after a short delay; abnormally rapid forgetting rate were found at longer intervals. This pattern of impairment does not lend itself to an easy interpretation. However, the hypothesis of a consolidation deficit may be advanced.

Hereditary sensory and autonomic neuropathy with ataxia and late onset

We report two brothers affected by a dominantly inherited form of hereditary sensory and autonomic neuropathy (HSAN), characterized by clinical features of sensory ataxia, and by late onset in the 6th decade. Sural nerve biopsy in the proband showed almost complete loss of myelinated fibers, and relative sparing of unmyelinated fibers. This family showed an atypical presentation of HSAN, which is usually characterized by acrodystrophic manifestations of infantile or juvenile onset. Although a few reports of HSAN presenting with late onset and/or ataxia appeared, this is the first report of a family with dominant HSAN characterized by late onset sensory ataxia.

Reaction time responses in parkinsonian and hemiparkinsonian patients

Twenty-one normal subjects, 32 bilateral parkinsonian patients (BPs) and 29 hemiparkinsonian patients (HP) were submitted to separate or sequentially associated motor tasks that included simple reaction times (RT), choice RTs, directional RTs, and movement RTs. The results showed that simple RTs, directional RTs, and movement times (MT) were slower in BPs as compared to normal subjects; for choice RTs there was no difference. Response patterns were similar in normal controls and BPs. In both groups RTs became more prolonged as sequentially programmed operations increased. If movement occurred at the end of the sequence, they prolonged the RTs of the preceding operations, but MTs per se did not vary. In HPs the same results were observed on the "bad" hand side versus normal controls and versus the healthy side, but a significant statistical level was reached mainly when the "bad" hand was the right one.

Head-injured subjects aged over 50 years: correlations between variables of trauma and neuropsychological follow-up

Neuropsychological follow-up was studied in 70 consecutive head-injured subjects aged over 50 years. Diffuse deterioration (28%), moderate deterioration (25%) and dementia (21%) were the most frequent sequelae. Analysis of correlations between neuropsychological sequelae and trauma variables showed that: (1) mild trauma did not necessarily imply good prognosis and could be followed by very severe consequences; (2) duration of post-traumatic amnesia was correlated with coma duration but not with neuropsychological outcome; (3) on the whole, no prognostic predictor of the outcome was found.

A case of unilateral opercular syndrome associated with a subcortical lesion

A patient who developed a unilateral opercular syndrome following a cerebrovascular accident is described. Computed tomography showed that the lesion did not affect the opercular cortex, but involved deep white matter and the head of the caudate nucleus of the left hemisphere. Persistent hypophonia and transient aphasia were associated. Comparison with previous cases is discussed.

Lateralization of visual attention in patients with classic migraine and unilateral prodromes

The present study is aimed to investigate whether and how mechanisms of visual attention are changed into conditions of monohemispheric disorders. For this purpose, Posner's paradygm was applied to classic migraine patients with prodromal phenomena localized in one hemisphere. The subjects were examined in acute phase (within 24 h of the episode end) and after a week or more from the episode (interparoxysmal phase). The patients in interparoxysmal phase behaved as normal subjects. In acute phase, we observed a selective involvement of attentional behaviour in migraineurs with left hemispheric symptoms. A possible explanation might be based on the well-known tendency of this hemisphere to prevail in performing attentive tasks.

Familial Alzheimer disease affecting only females

A family lineage is reported in whom several subjects, all of them females, suffered from SDAT. The existence of a subgroup of inherited dementias affecting only females is discussed.

Transient global amnesia: definition and clinical phenomenology

Based on personal observations and analysis of the most impressive literature, some considerations are made on transient global amnesia definition and clinical phenomenology.

Discriminant analysis of WAIS results in different types of dementia and depressed patients

A Multivariate Analysis of Covariance and Discriminant Analysis were carried out on complete WAIS profiles obtained from three groups of demented patients: Multi-Infarct Dementia patients, Senile Dementia of Alzheimer Type patients, and Alcoholic Dementia patients. A group of middle-aged Depressed patients was also included. WAIS did not differentiate among dementias, but Picture Completion and Block Design subtests proved to be effective in differentiating dementia from depression.

Involuntary grasping and groping responses to space-related visual stimuli

Involuntary groping-grasping responses to visual stimuli were studied in relation to the location of the stimuli in the space surrounding the patient. The following space-related patterns of stimulus-response were observed in four patients: (a) responses were evoked only by visual stimuli in the hemispace ipsilateral to the arm involved; (b) responses were evoked only by visual stimuli within the reach of maximal arm extension; (c) responses were evoked only by visual stimuli in the space around the hand; (d) all such patterns were variously combined. These findings are discussed in relation to the general problem of specific correlations between sensorimotor subsystems and peripersonal behavioral space.

Analysis of higher nervous functions in migraine and cluster headache

Three groups of patients, long-time sufferers from classic migraine, common migraine, and cluster headache respectively, and three control groups, age- education- and sex-matched, underwent a set of neuropsychological tests and tachistoscope tasks in order to evaluate cognitive functions and interhemispheric balance. Migraineurs and cluster headache patients were selected on the basis of the constant (90%) unilaterality of both pain and focal neurological deficits. No significant differences emerged between patients and controls in any of the neuropsychological and tachistoscopic tasks administered, thus indicating that between attacks of migraine as well as of cluster headache no evidence of cortical dysfunction is detectable.

Changes in interhemispheric functional balance in epileptic and migraine patients

In relation to the general problem of neuropsychological conditions in epileptic and migraine patients, the literature is reviewed and new data are presented emphasizing the specific heuristic value of methods investigating interhemispheric functional balance. Available data indicate that: a) in epileptic monohemispheric non-lesional patients an interhemispheric functional change in favour of the epileptic hemisphere is detectable, more manifest when the left hemisphere is involved; b) in migraine patients interhemispheric functional changes are detectable only during the paroxysmal phase, more manifest when the left hemisphere is involved.

Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly

The histories of seven patients over the age of 60 years are reported. They all suffered from recurrent and prolonged episodes of confusional state associated with psychic and neurologic manifestations. All episodes were accompanied by the occurrence of periodic lateralized epileptiform discharges (PLEDs) on the EEG, which became normal when the ictal episodes subsided either spontaneously or after administration of diazepam i.v. Although PLEDs may correspond to severe hemispheric lesions, serial computed tomography (CT) scan and laboratory investigations detected significant abnormalities in only one case, that of a patient with a progressive dementing outcome. In the other six patients, follow-up neuropsychological controls indicated moderate impairment of higher cortical functions according to the hemisphere involved by PLEDs. Administration of carbamazepine (CBZ) proved rather effective in preventing the recurrence of the ictal episodes. For its clinical, EEG, and prognostic features, this condition may represent a peculiar nonconvulsive status epilepticus in the elderly.

Neuropsychological deficits in arterial hypertension

Sixty subjects with uncomplicated essential hypertension and 60 matched normal subjects were submitted to neuropsychological tests in order to establish whether some impairment of cognitive functions can be evidenced even in those hypertensive subjects that are in this respect asymptomatic on standard examination and interview. The hypertensive subjects obtained significantly poorer results than normotensive subjects on memory, visuo-motor and performance tests. In the control group, the classic negative correlation pattern between age and scores was observed, while in the patient group this correlation could be confirmed only in a few tests. Subgrouping of patients according to hypertension duration and treatment showed that the impairment of cognitive functions manifested itself very early and did not tend to progress within 6-10 years of hypertension duration.

Hemispheric prevalence changes in partial epileptic patients on perceptual and attentional tasks

In relation to the general issue of the long-term effects of epileptic activity on the higher nervous functions, monohemispheric epileptic patients--divided into "lesional" [i.e., with computed tomography (CT) scan-visible lesions] and "nonlesional" (i.e., with CT scan-nonvisible lesions)--were submitted to dichotic verbal and tonal tasks, dichoptic verbal and spatial tasks, and a visual tachistoscopic attentional task. The aim was to investigate whether the typical patterns of hemispheric prevalence, which were observed in normal subjects by using these tests, undergo significant changes in epileptic patients. The findings versus normal subjects seem to demonstrate that (a) in lesional epileptic patients, the prevalence of the hemisphere without macroscopic lesions is a constant rule, whether or not this hemisphere is prevalent in normal subjects; (b) in nonlesional epileptic patients, the patterns are the following: when the epileptic hemisphere is the one that is prevalent in normal subjects, its prevalence is enhanced, whichever the hemisphere; when the epileptic hemisphere is not the hemisphere prevalent in normal subjects, the left one attracts and maintains prevalence, whereas the right one reduces and variously interferes with contralateral prevalence. It is concluded that, with respect to the functions tested, the nature of the epileptic foci seems to influence markedly the interhemispheric prevalence pattern.

Unilateral visual agnosia

A case of unilateral visual agnosia for all types of stimuli limited to the left visual hemifield and associated with a right occipital temporal vascular lesion is reported. Questions raised by this case of hemiagnosia as compared to previous ones are discussed.

Interhemispheric differences in same versus different judgments upon presentation of complex visual stimuli

An experiment is reported which was aimed at investigating interhemispheric differences upon tachistoscopic presentation of Same vs Different stimuli, i.e. pairs of 16-side Vanderplas and Garvin figures selected for their complexity, unfamiliarity and lack of verbalization. The right hemisphere was found to be faster and more accurate in Same judgements and the left hemisphere in Different judgements. These findings seem to further confirm the assumption that the right hemisphere would mostly use a holistic strategy and the left hemisphere an analytic strategy.

Exposure-effect and exposure-response relationships between occupational exposure to styrene and neuropsychological functions

A neuropsychological test battery was administered to 50 workers exposed to styrene and to 50 sex-, intelligence-, and age-matched controls. The main styrene metabolites, ie, mandelic acid (MA) and phenylglyoxylic acid (PGA), were measured as exposure indices in the urine collected on Saturday mornings, just before neuropsychological testing. Exposure-response and exposure-effect relationships were found between the intensity of the exposure (as reflected by the sum of MA and PGA) and the scores of the neuropsychological tests. Verbal learning skills were significantly impaired in workers with a sum of MA and PGA higher than 150 mmole/mole creatinine, corresponding to styrene airborne concentrations higher than 25 ppm (mean daily exposure). Logical memory and visuo-constructive abilities were shown to be significantly affected in workers with MA and PGA higher than 300 mmole/mole creatinine, corresponding to exposure levels of more than 50 ppm of styrene in air.

[Neuropsychologic and behavioral sequelae of cranial injuries: remarks on classification, diagnosis and correlation with injury variables]

The psychological and behavioural impairment following head injury has been investigated in order to throw light on and assess the related epidemiological aspects, methodological approaches, clinical manifestations, and the correlations between the sequelae and the variables of head trauma, i.e. degree of severity of trauma, age of patients, presence or absence of fractures and haematoma. This study was conducted on 117 head- injured patients and 43 matched "control" subjects. The findings point out the following: a) Even the medical staff is often largely misinformed about this type of sequelae. The methods used for assessment should therefore be further developed and a more systematic evaluation of the higher functions following head injury appears to be necessary. b) The syndromes observed are mostly of a composite and diffuse type. It is therefore difficult to classify them according to strict criteria; indeed, it appears that the only possible approach is to define large groups of head- injured patients based on clinical description, which are partly borne out and partly described ex novo in the present series. c) As regards the correlations between the variables of the injury and the resulting neuropsychological impairment, the age factor should be distinguished from the severity of injury. If it is true that the older patients, the greater the impairment, such a direct correlation no longer exists when severity of the injury is considered. Indeed, the latter does not appear to be a significant differential factor in determining the degree of impairment. Similarly, whether the injury is an "open" or "closed" one, or the presence of haematoma do not appear to be differential factors, either.

Is prosopagnosia more frequent in males than in females?

A case review of prosopagnosia was carried out and male-female incidence of the disorder compared to relative male-female incidence of cerebro-vascular disease in general. Prosopagnosia was found to occur significantly more frequently in males than in females. Possible implications of this finding vis-à-vis male-female differences in cerebral organization are discussed and topics for further investigation are suggested.

Contrasting cases of Italian agrammatic aphasia without comprehension disorder

Two patients with agrammatic speech and unimpaired comprehension are presented and contrasted. Case 1 had an infarction involving precentral gyrus, subjacent white matter, and posterior and superior aspects of the insula, largely sparing Broca's area. His speech was slow and dysarthric, consisting of short disconnected phrases with some omission of lexical verbs. Case 2 had an unusual transient aphasia of acute onset without hemiplegia; speech rate, articulation, and sentence length and complexity appeared normal. Both patients tended to omit function words and finite verb inflections, but Case 2 did so much more than did Case 1. Neither patient showed impairment in any other area of language performance. Tentatively, Case 2 is described as being more morphologically impaired but less syntactically impaired than Case 1, while neither has damage to a central language processor.

Hemispheric prevalence in acoustical attention

Two experiments were conducted in which monaural clicks were presented to the right or left ear preceded by binaural verbal (Experiment 1) and musical (Experiment 2) warnings. After the "neutral" warnings, the clicks could be presented to the right or left ear equally often (50%); after the warnings which directed the attention to the left or right ear, the clicks could be presented to either the "expected" (67%) or to the "unexpected" (33%) ear. In Experiment 1 there was a cost effect for the "unexpected" ear and reaction times were significantly faster when the clicks were presented to the right ear. In Experiment 2, the musical warnings brought about a cost effect while no significant ear advantage was observed.

[Lateralization of attention in the acoustic modality]

Posner reported that knowledge of where in space a visual stimulus will occur ("expected" condition), improves detection ("benefit"), as measured by response latencies, while response latencies became longer ("cost") when visual stimulus position is "unexpected" and intermediate when the visual stimulus position is "neutral". The authors have tried to replicate this finding in the acoustical modality. One hundred-twenty acoustical stimuli (clicks) were presented to the right and the left ear of ten right handed subjects, preceded by the biaural verbal warnings "right", "left" or "center". After the "center" verbal warning, the clicks could be presented to the right or the left ear equally often (50%): "neutral" condition; after the "right" or "left" verbal warnings, the clicks could be presented in 80% of cases to the "expected" ear and in 20% of cases in "unexpected" ear. The results suggested that: a) reaction times are significantly faster when the clicks are presented to the right ear; b) the "cost" effect is present but not the "benefit" effect, since no difference was shown between reaction times in the "neutral" and in the "expected" conditions; c) the right ear advantage disappears in the "unexpected" condition after the "right" verbal warning only. The authors discuss the results in relation to the attentional interhemispheric theories.

A case of receptive amusia with prominent timbre perception defect

A patient with a right temporal lesion is described who, in recognising sounds and noises, complained of deficits which seemed to be most evident when sounds and noises could be recognised mainly by timbre whereas no deficit was noticed when pitch and rhythm were the main indicators. In addition, some global distortions in musical appreciation were complained of and described as "resonance" or "loss of aesthetic pleasure".

Hemispheric dominance in the perception of tonal sequences in relation to sex, musical competence and handedness

Sixty right-handed non-musician subjects, thirty males and thirty females, and thirty right-handed musician subjects, seventeen males and thirteen females, were submitted to dichotically presented tonal sequences. Immediate identification procedure with preliminary training was used. The results point out that both, musicians and non-musicians, males and females, show significant left ear dominance. The left ear dominance was more frequent in musicians. The results are discussed in the light of the "analytic-synthetic" theory of Bever and Chiarello and the "temporal" theory of Gordon.

Focal lesion of the right cingulum: a case report in a child

A body with a focal lesion of the right cingulum, subjected to cingulectomy for the removal of a tumour, is the first case of an isolated unilateral cingulum lesion to be reported. The presenting symptoms consisted of serious behavioural abnormalities: lack of social restraint, heightened sexuality, bulimia and aggressiveness, all of which ceased after surgery. Neuropsychological tests, done before and after the operation, provided no evidence that the higher cognitive functions, including memory, were impaired.

Neuropsychological testing during a transient global amnesia episode and its follow-up

A case of transient global amnesia has been neuropsychologically assessed during the attack. Global involvement of any memory modalities and far-reaching retrograde amnesia were found. Follow-up retesting, 1 week and 6 months later, showed persistence of mild verbal memory impairment.

Neuropsychological functions in the follow-up of transient global amnesia

Sixteen patients, who had suffered only one episode of transient global amnesia and showed no clinically evident abnormalities in their follow-up, were examined with psychometric and memory tests. Deficits in verbal long-term memory and in verbal IQ were found. These observations seem to demonstrate that in transient global amnesia patients regarded as being 'normal' in their follow-up there is no complete recovery and the sequelae seem to conform to a definite pattern. Problems of nosology and localization are discussed.

[Case studies of left unilateral apraxia]

The authors report two cases of motor apraxia, agraphia and tactile anomia on the left side, associated with bilateral constructive apraxia. These cases are discussed in relation to their unusual etiology and in relation to possible pathogenetic hypothesis other than classical Liepmann's scheme.

Responses to dichotic listening tasks in temporal epileptics with or without clinically evident lesions

Dichotic listening was studied in two groups of temporal epileptics with monolateral circumscribed EEG focus: the first presenting with signs of brain damage and the second free from these signs. The lesional group tended to prefer the ear ipsilateral to the side of lesion, while subjects with non-lesional focus tended to prefer the ear contralateral to the side of focus. The results are discussed and compared with other observations in this field.

[Prevalent frequency of prosopagnosia in males]

In order to find out how frequent prosopagnosia is in males in comparison to females, all cases hitherto published have been reviewed and a remarkably greater frequency in males has been pointed out. Since the etiology has resulted to be in the majority of cases vascular, the epidemiology of vascular diseases as possible factor of this different incidence is discussed. It is concluded that the greater frequency observed in males seem to be a real fact inherent to prosopagnosia, and not related to other factors.