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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
University Children's Hospital Berne, Switzerland. julia.pavlovic@insel.ch
J
J
Pavlovic
F
F
Kaufmann
E
E
Boltshauser
A
A
Capone Mori
D
D
Gubser Mercati
C-A
CA
Haenggeli
E
E
Keller
J
J
Lütschg
J-P
JP
Marcoz
G-P
GP
Ramelli
E
E
Roulet Perez
T
T
Schmitt-Mechelke
M
M
Weissert
M
M
Steinlin
D000293:Adolescent; D000367:Age Factors; D020520:Brain Infarction / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000502:physiology*; D007361:Intelligence Tests; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D012727:Sex Characteristics; D020521:Stroke / Q000503:physiopathology*; D013557:Switzerland / Q000453:epidemiology