Neuropsychological problems after paediatric stroke: two year follow-up of Swiss children

• Published in: Neuropediatrics Vol. 37; no. 1; p. 13
• Main Authors: Pavlovic, J, Kaufmann, F, Boltshauser, E, Capone Mori, A, Gubser Mercati, D, Haenggeli, C-A, Keller, E, Lütschg, J, Marcoz, J-P, Ramelli, G-P, Roulet Perez, E, Schmitt-Mechelke, T, Weissert, M, Steinlin, M
• Format: Journal Article
• Language: English
• Published: Germany 01-02-2006
• Subjects: Adolescent; Age Factors; Brain Infarction - pathology; Brain Infarction - physiopathology; Child; Child, Preschool; Educational Status; Female; Follow-Up Studies; Humans; Intelligence - physiology; Intelligence Tests; Male; Mental Processes - physiology; Neuropsychological Tests - statistics & numerical data; Outcome Assessment (Health Care); Sex Characteristics; Stroke - physiopathology; Switzerland - epidemiology; Switzerland
• ISSN: 0174-304X
• DOI: 10.1055/s-2006-923932

The aim of this study was to obtain information about neurological and cognitive outcome for a population-based group of children after paediatric ischaemic stroke.
Data from the Swiss neuropaediatric stroke registry (SNPSR), from 1.1.2000 to 1.7.2002, including children (AIS 1) and neonates (AIS 2). At 18-24 months after a stroke, a follow-up examination was performed including a history, neurological and neuropsychological assessment.
33/48 children (22 AIS 1, 11 AIS 2) participated in the study. Neurological outcome was good in 16/33. After childhood stroke mean IQ levels were normal (94), but 6 children had IQ < 85 (50-82) and neuropsychological problems were present in 75%. Performance IQ (93) was reduced compared to verbal IQ (101, p = 0.121) due to problems in the domain of processing speed (89.5); auditory short-term memory was especially affected. Effects on school career were common. Outcome was worse in children after right-sided infarction. Children suffering from stroke in mid-childhood had the best prognosis. There was no clear relationship between outcome and localisation of the lesion. After neonatal stroke 7/11 children showed normal development and epilepsy indicated a worse prognosis in the remaining 4.
After paediatric stroke neuropsychological problems are present in about 75% of children. Younger age at stroke as well as an emergence of epilepsy were predictors for worse prognosis.