Deficits of higher cortical functioning in two patients with posterior parietal arteriovenous malformations. Use of the standardized Luria-Nebraska Neuropsychological Battery for pre- and postoperative assessment

The Standardized Luria-Nebraska Neuropsychological Test Battery was used for pre- and postoperative evaluation of two patients, each of whom had a large posterior parietal arteriovenous malformation (AVM) of the left cerebral hemisphere. In both cases the AVMs, which were fed by the left anterior, middle, and posterior cerebral arteries, were resected completely. These cortical lesions, which were almost identical in anatomical location and pathophysiology, produced deficits in higher cortical functioning that were remarkably similar in the two patients studied. Disorganization of spatially based complex speech and confusion with arithmetic and writing functions were the most prominent pre- and postoperative problem areas. Other functions that had been mildly abnormal preoperatively had improved at the last testing session 6 months postoperatively. The test battery is easy to administer, has standardized scoring, requires only 2.5 hours of testing time, and produces reliable, reproducible results. Our initial experience with this test battery suggests that it is readily applicable to patients with neurosurgical disease and may be of benefit in planning appropriate rehabilitation and in obtaining knowledge that will increase our understanding of complex brain functions.