Differences in vulnerability between the hemispheres in early childhood and adulthood |
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Authors: | Ch Njiokiktjien |
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Institution: | (1) Developmental Dysphasia Foundation, WG-Plein 316 NL-1054 SG Amsterdam, The Netherlands |
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Abstract: | There are more left hemisphere damaged than right hemisphere damaged children and adults if one relies on studies of congenital
hemiparesis as well as on those done on groups with radiologically demonstrated perinatal and postnatal unilateral stroke,
hemispherectomy, or unilateral epilepsy in childhood or adulthood. The main pathogenetic factor seems to be a hemodynamic
one, responsible for insufficient blood supply to the left hemisphere. Since adults show a difference in the same direction
as children, the blood supply to the left internal carotid artery would seem to be the crucial factor. Around birth, an open
ductus arteriosus may play an additional role. The hemodynamic asymmetry does not exclude an intrinsic maturational hemispheric
tissue factor, making the left hemisphere more vulnerable than the right to detrimental influences around birth and during
the early postnatal period. Immature white matter is especially vulnerable to asphyxia.
The text was submitted by the author in English. |
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