title: A cognitive and affective pattern in posterior fossa strokes in children: a case series.
abstract: OBJECTIVE
  Posterior fossa strokes account for about 10% of ischaemic strokes in children. Although motor and dysautonomic symptoms are common, to our knowledge cognitive and affective deficits have not been described in the paediatric literature. Our aim, therefore, was to describe these symptoms and deficits.
  
  
  METHODS
  In a retrospective study, we included all cases of posterior fossa strokes in children occurring at a single centre between 2005 and 2007, and investigated cognitive and affective deficits.
  
  
  RESULTS
  Five males aged 3 to 14 years met the inclusion criteria. They all presented very early with mood disturbances: outbursts of laughter and/or crying and alternating agitation or prostration that disappeared spontaneously within a few days. Persistent cognitive deficits were also diagnosed in all five: initial mutism, then anomia, followed by comprehension deficiency and deficiencies of planning ability, visual-spatial organization, and attention. Despite early and intensive rehabilitation, recovery from these cognitive deficits was slow and sometimes incomplete, and on follow-up they proved to be more disabling than the motor symptoms.
  
  
  CONCLUSIONS
  These findings are similar to the cerebellar cognitive affective syndrome described in adults, and quite similar to the language and affective deficits observed in children after surgery for posterior fossa tumour. This is consistent with the role of the cerebellum and brainstem in affective and cognitive processes from early development.
authors.affiliation: Paediatric Neurology Department, Hôpital Necker-Enfants Malades, APHP, 149 rue de Sévres, Paris, France. manoelle.kossorotoff@nck.aphp.fr
authors.forename: Manoelle
authors.initials: M
authors.lastname: Kossorotoff
authors.forename: Coralie
authors.initials: C
authors.lastname: Gonin-Flambois
authors.forename: Cyril
authors.initials: C
authors.lastname: Gitiaux
authors.forename: Susana
authors.initials: S
authors.lastname: Quijano
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.forename: Nadia
authors.initials: N
authors.lastname: Bahi-Buisson
authors.forename: Christine
authors.initials: C
authors.lastname: Barnerias
authors.forename: Olivier
authors.initials: O
authors.lastname: Dulac
authors.forename: Francis
authors.initials: F
authors.lastname: Brunelle
authors.forename: Isabelle
authors.initials: I
authors.lastname: Desguerre
mesh_terms: D000293:Adolescent; D000339:Affect; D001921:Brain / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications*; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019964:Mood Disorders / Q000150:complications*; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000473:pathology