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gistfile1.txt

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Bowers</field><field name=\\\"desc_metadata__creator_sim\\\">Thomas G. Bowers</field><field name=\\\"desc_metadata__contributor_tesim\\\">Struck, Bowers, McCloskey 2003</field><field name=\\\"desc_metadata__contributor_sim\\\">Struck, Bowers, McCloskey 2003</field><field name=\\\"desc_metadata__description_tesim\\\">A 41 year-old college student, referred for a psychoeducational assessment to rule out attention and learning difficulties, revealed a pattern of inconsistent test results, indicating significant cognitive impairment. Subsequent neuropsychological evaluation and neurological follow-up confirmed cerebral impairment, and a MRI scan confirmed a neoplasm in the left frontal cortex, which was treated surgically. This paper reviews three serial assessment batteries, and treatment summaries as the individual progressed over a three year period.&#13;\\n</field><field name=\\\"desc_metadata__tag_tesim\\\">Conference Papers</field><field name=\\\"desc_metadata__tag_sim\\\">Conference Papers</field><field name=\\\"desc_metadata__rights_tesim\\\">All rights reserved</field><field name=\\\"desc_metadata__publisher_tesim\\\">Innoventure</field><field name=\\\"desc_metadata__publisher_sim\\\">Innoventure</field><field name=\\\"desc_metadata__date_created_tesim\\\">2003</field><field name=\\\"desc_metadata__date_uploaded_dtsi\\\">2014-04-02T00:00:00Z</field><field name=\\\"desc_metadata__date_modified_dtsi\\\">2014-04-02T21:07:42Z</field><field name=\\\"desc_metadata__subject_tesim\\\">Brain--Tumors--Diagnosis</field><field name=\\\"desc_metadata__subject_sim\\\">Brain--Tumors--Diagnosis</field><field name=\\\"desc_metadata__language_tesim\\\">English</field><field name=\\\"desc_metadata__language_sim\\\">English</field><field name=\\\"depositor_ssim\\\">dvo</field><field name=\\\"depositor_tesim\\\">dvo</field><field name=\\\"has_model_ssim\\\">info:fedora/afmodel:GenericFile</field><field name=\\\"is_part_of_ssim\\\">info:fedora/scholarsphere:sf2689042</field><field name=\\\"label_tesim\\\">Struck, Bowers, McCloskey 2003.ppt</field><field name=\\\"noid_tsi\\\">sf268912r</field><field name=\\\"file_format_tesim\\\">vnd.ms-powerpoint (PPT, Microsoft Powerpoint Presentation)</field><field name=\\\"file_format_sim\\\">vnd.ms-powerpoint (PPT, Microsoft Powerpoint Presentation)</field><field name=\\\"all_text_timv\\\">\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\nPowerPoint Presentation\\n\\nDonna M. Struck, Philadelphia College of Osteopathic Medicine; Thomas G. Bowers, Penn State Harrisburg;\\n Lawrence McCloskey, Hershey Medical Center\\n\\n \\n\\n\\n\\n\\n\\n\\n\\t\\t\\n\\t\\t\\tAbstract\\n\\nA 41 year-old college student, referred for a psychoeducational assessment to rule out attention and learning difficulties, revealed a pattern of inconsistent test results, indicating significant cognitive impairment. Subsequent neuropsychological evaluation and neurological follow-up confirmed cerebral impairment, and a MRI scan confirmed a neoplasm in the left frontal cortex, which was treated surgically. This paper reviews three serial assessment batteries, and treatment summaries as the individual progressed over a three year period.\\n\\n\\tHe has been free of cancer of eighteen months, but the neurologists had warned that the tumor was one a rapid and aggressive growth and reoccurrence. He is active in a support group but he continues to experience tension and anxiety. In addition, the deleterious effects of radiation treatment are often delayed by more than a year. He also participated in psychotherapy sessions reevaluating his achievements, difficulties and future goals. In general, he demonstrated improved neuropsychological functioning on post-surgery assessment, with improved scores noted on the Category Test, the Tactual Performance Test, the Seashore Rhythm Test and Trails A. Category Test results were in the mildly impaired range, however, and TPT scores were weak on nondominant (left) hand and both handed performance. TPT Localization score remained weak. His finger tapping speed slowed, although not in the impaired range, and he continued to have significant difficulty with Trails B. His memory abilities largely improved into the average range, but working memory scores remained very low.\\n\\t\\t\\tConclusions\\n\\tThe finding of a glioblastoma multiforme frontal tumor with an individual presenting as an individual with a specific learning disorder is certainly unusual. Nevertheless, these findings indicate that practitioners need to consider the possibility of significant serious and severe cerebral factors impacting on learning in the course of psychoeducational assessment. At a minimum, it is argued the psychoeducational evaluations need to include assessment of memory functions and the use of screening instruments for brain-behavioral compromise. Findings of impairment in memory or signs of brain-behavioral impairment should dictate more comprehensive follow-up with neuropsychological tests and neurological consultation.\\n \\n \\n\\n\\tA 41 year-old male non-traditional student was initially referred for an evaluation of this intellectual and academic functioning because of concerns about his academic performance. While his demeanor was pleasant, he was also anxious, and he complained of “extreme test anxiety.” His mood and affect was normal, but thinking and mentation was slow. His speech was difficult and marked by extreme word-finding difficulty, and aphasic production was noted on intake. Initial assessment indicated functioning in the low average range, but with a significant difference between his Verbal and Performance IQ, favoring his Verbal IQ score. He demonstrated a significant and severe elevation on a deterioration index of .43. He demonstrated significantly strong abilities on verbal comprehension scores, relative to significantly weaker scores on perceptual organization and working memory abilities. He performed poorly on tasks which required him to assemble abstract stimulus materials. He performed atypically on the Conner’s Continuous Performance Test (CPT), as well demonstrating difficulty with age-level tasks in reading and language. He also performed poorly on assessment of visual memory by the Benton Visual Retention Test. The pattern of results implicated right –hemisphere type dysfunction, with left-hemisphere processing deficits in expressive and receptive aphasia. He was evaluated on neuropsychological functioning and those results indicated a high likelihood of acquired cerebral impairment, with problems in construction apraxia, spelling apraxia, acalculia, and alexia. It was also noted that there were left-sided sensory perceptual errors and his visual fields were compromised. He had a great deal of difficulty with abstract thinking and executive functioning, and milder but still significant difficulty with central auditory processing. Remarkably, his simple psychomotor speed was actually above average. \\n\\t\\nFigure 1.\\nThis example of a glioblastoma multiforme tumor here was provided by the Penn State Hershey Medical Center's Neuropathology Laboratory, Hershey, PA, operated under the direction of Dr. Jay Towfighi.\\n\\nTable 1.\\nInitial Psychoeducational Assessment Pre-Surgery\\nWechsler Adult Intelligence Scale – Revised (WAIS-R) Results\\nVerbal Scaled Scores\\t\\t\\t\\tPerformance Scaled Scores\\nInformation\\t\\t11\\t\\t\\tPicture Completion\\t5\\nDigit Span\\t\\t  7\\t\\t\\tPicture Arrangement\\t8\\nVocabulary\\t\\t10\\t\\t\\tBlock Design  \\t\\t4\\nArithmetic\\t\\t  4\\t\\t\\tObject Assembly\\t\\t9\\nComprehension\\t\\t  8\\t\\t\\tDigit Symbol\\t\\t5\\nSimilarities\\t\\t11\\nVerbal IQ \\t\\t91\\nPerformance IQ\\t\\t79\\nFull Scale IQ\\t\\t84\\n\\nWoodcock-Johnson – Revised (WJ-R) Results \\nScale\\t\\t\\t\\tSS\\tPercentile\\nBroad Reading \\t\\t\\t95\\t     37\\nBroad Wrtn Lang\\t\\t\\t76\\t       5\\nLW Ident\\t\\t\\t98\\t     44\\nPass Comp\\t\\t\\t91       \\t     28\\t\\t\\nCalculation\\t\\t\\t81     \\t     11\\nDictation\\t\\t\\t78                 7 \\t\\nWriting Samples\\t\\t\\t78    \\t      7\\t\\nVerbal Memory (MAS)\\t\\t84\\t     14\\n \\nTable 2.\\nHalstead-Reitan Neuropsychological Battery Results Pre-Surgery\\nTest\\t\\t\\t\\tRaw Score\\t\\tSignificant\\nCategory Test\\t\\t\\t95 errors\\t\\t\\t     *\\n Tactual Performance Test\\t\\t18.64’\\t\\t\\t     *\\t\\t\\n-Dominant Hand\\t\\t \\t 9.30’ \\t\\t\\t     *\\n-Nondominant Hand\\t\\t  6.17’\\t\\t\\t     *\\n-Both Hands\\t\\t\\t  3.17’\\t\\t\\t     * \\n-Memory\\t\\t\\t   6\\t\\t\\t          \\n-Localization\\t\\t\\t   4\\t\\t\\t     *\\t\\t\\t\\nFinger Tapping Test\\t\\t\\n-Dominant Hand\\t\\t\\t 61.0\\n-Nondominant Hand\\t\\t 54.2\\nSpeech Sounds Test\\t\\t 4 errors\\nSeashore Rhythm Test\\t\\t 9 errors\\t\\t\\t     *\\n Trails A\\t\\t\\t\\t 51”\\t\\t\\t     *\\t\\nTrails B\\t\\t          \\t\\t 199” \\t\\t\\t     *\\n \\nTable 3.\\nNeuropsychological Results Post-Surgery\\n1. Wechsler Adult Intelligence Scale – Revised (WAIS-R) Results\\nVerbal Scaled Scores\\t\\t\\t\\tPerformance Scaled Scores\\nInformation\\t\\t10\\t\\t\\tPicture Completion\\t\\t5\\nDigit Span\\t\\t  7\\t\\t\\tPicture Arrangement\\t\\t5 \\nVocabulary\\t\\t  9\\t\\t\\tBlock Design \\t\\t\\t5\\t\\nArithmetic\\t\\t  6\\t\\t\\tObject Assembly\\t \\t            10\\nComprehension\\t\\t  7\\t\\t\\tDigit Symbol\\t\\t\\t5\\nSimilarities\\t\\t  8\\nVerbal IQ \\t\\t89\\nPerformance IQ\\t\\t81\\nFull Scale IQ\\t\\t84\\n\\n2. Woodcock-Johnson – Revised (WJ-R) Results \\nScale\\t\\t\\t\\tSS\\tPercentile\\nBroad Reading \\t\\t\\t92\\t    30\\nBroad Wrtn Lang\\t\\t\\t85\\t    16\\nLW Ident\\t\\t\\t98\\t    45\\nPass Comp\\t\\t\\t84      \\t     14 \\t\\t\\nCalculation\\t\\t\\t80     \\t      9 \\nDictation\\t\\t\\t85               16 \\t\\nWriting Samples\\t\\t\\t92    \\t    30 \\t\\n\\n3. Wechsler Memory Scale - III \\t\\nScale\\t\\t\\t\\tSS\\tPercentile\\nAuditory Immediate\\t\\t92\\t    30\\nVisual Immediate\\t\\t\\t94              34\\nImmediate Memory\\t\\t91\\t    27 \\nAuditory Delayed\\t\\t\\t97              42\\nVisual Delayed\\t\\t\\t88              21\\nAud Recogn Delayed        \\t   \\t 100\\t    50\\nGeneral Memory\\t\\t\\t92              30\\nWorking Memory\\t\\t66                1\\n\\t \\n4. Halstead-Reitan Battery\\n\\t\\t\\t\\tRaw Score\\tSignificant\\nCategory Test\\t\\t\\t69 errors\\t\\t   *\\nTactual Performance Test\\t\\t 16.80’\\t\\t   *\\t\\t\\n-Dominant Hand\\t\\t \\t 6.52’ \\t\\t\\t    \\n-Nondominant Hand\\t\\t  5.72’\\t\\t   *\\n-Both Hands\\t\\t\\t  4.65’\\t\\t   * \\n-Memory\\t\\t\\t   7\\t\\t\\t\\t\\n-Localization\\t\\t\\t   3\\t\\t   *\\t\\t\\t\\nFinger Tapping Test\\t\\t\\n-Dominant Hand\\t\\t \\t49.0\\n-Nondominant Hand\\t\\t 47.6\\nSpeech Sounds Test\\t\\t 3 errors\\nSeashore Rhythm Test\\t\\t 6 errors\\t\\t    \\nTrails A\\t\\t\\t\\t 35”\\t   \\t\\t\\t\\t\\t    \\t\\nTrails B\\t   \\t        \\t\\t237” \\t\\t  *\\t    \\n\\n\\tBecause of the severity of his difficulties, a neurological follow-up was arranged for him. At the time he presented to the neurologist’s office, approximately two weeks later, there were persistent headaches, lethargy, and right arm weakness. Speech and cognitive abilities had diminished even further. The results of a MRI scan revealed a roughly 5 x 5 x 5 cm cystic neoplasm in the posterior left frontal lobe, producing vasogenic edema. Neurological evaluation indicated right hemiparesis, dysarthia, ataxia, and impairment in memory and concentration. After a left frontal craniotomy for a gross total resection of a glioblastoma multiforme his neurological deficits improved. He also received a course of whole – brain radiation. Follow-up MRI scans detected a roughly 3 x 3 cm hematoma at the surgical site, showing the expected evolution. Six months later, the postoperative cyst had decreased to two cm. in size.\\n\\tOne year follow-up indicated psychomotor speed had declined mildly, but scores were still in or near the normal range. There were inconsistent indications of impairment in attention and concentration, but formerly poor memory and concept formation skills had normalized, and tactile problem solving skills remained broadly normal. His intellectual and achievement remained the low average range, but the spread between his verbal and performance abilities had decreased\\n[1] The authors are grateful to Family Development Services for providing the opportunity to review this case and support for this paper.\\nFrontal Glioblastoma Multiforme Tumor: Presentation as a Specific Learning Disorder[1]\\n \\n\\n\\n\\n*</field></doc></add>\"\n\nBacktrace: /opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rsolr-1.0.10/lib/rsolr/client.rb:283:in `adapt_response'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rsolr-1.0.10/lib/rsolr/client.rb:190:in `execute'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rsolr-1.0.10/lib/rsolr/client.rb:176:in `send_and_receive'\n(eval):2:in `post'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rsolr-1.0.10/lib/rsolr/client.rb:82:in `update'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rsolr-1.0.10/lib/rsolr/client.rb:102:in `add'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/active-fedora-7.1.0/lib/active_fedora/solr_service.rb:141:in `add'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/active-fedora-7.1.0/lib/active_fedora/indexing.rb:72:in `update_index'\n(irb):20:in `block in irb_binding'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rubydora-1.8.0/lib/rubydora/repository.rb:73:in `call'\n/opt/heracles/deploy/scholarsphere/shared/bundle/ruby/2.1.0/gems/rubydora-1.8.0/lib/rubydora/repository.rb:73:in `block in search'>