title: Long-term sequelae after acquired pediatric hemorrhagic cerebellar lesions.
abstract: OBJECTIVE
  The aim of the present study was to assess cognitive, affective, and motor long-term sequelae after acquired focal pediatric cerebellar lesions.
  
  
  METHODS
  Eight patients with a history of isolated acquired hemorrhagic cerebellar lesions before the age of 13 participated in this study. All participants underwent a neurologic examination, including the Zurich Neuromotor Assessment (ZNA) and the International Cooperative Ataxia Rating Scale (ICARS). Cognitive functions have been evaluated with a general cognitive assessment and an extensive neuropsychological battery. Furthermore, patients and parents filled in questionnaires about quality of life and possible behavioral or emotional problems.
  
  
  RESULTS
  The results revealed that all patients exhibited motor problems (ZNA). Most participants had further restricted oculomotor movements (ICARS). Age at injury and the full scale IQ were significantly positively correlated (Pearson correlation 0.779; p = 0.023). Conversely, no overall neuropsychological profile could be identified except for marginally reduced reaction times and susceptibility to interference. In addition, borderline results in semantic and phonemic word fluency tasks were apparent. A dysexecutive syndrome was diagnosed in one patient. However, verbal performance and reading abilities were non-pathologic in all participants. The patients reported having a good quality of life without major physical restrictions.
  
  
  CONCLUSIONS
  Emotional disturbances and the presence of a mild cerebellar cognitive affective syndrome (as frequently described in adult patients) could only be confirmed in adolescents with vermis lesions. Nevertheless, in laboratory conditions, neuropsychological impairments were present in all patients. Heterogeneity of age at injury and exact lesion site may have led to interpersonal differences in neuropsychological outcome.
authors.affiliation: Department of Pediatric Neurology (J212), University Children's Hospital, Inselspital, 3010, Bern, Switzerland. kevin.wingeier@gmail.com
authors.forename: Kevin
authors.initials: K
authors.lastname: Wingeier
authors.forename: Sandra
authors.initials: S
authors.lastname: Bigi
authors.forename: Marwan
authors.initials: M
authors.lastname: El-Koussy
authors.forename: Theda
authors.initials: T
authors.lastname: Heinks-Maldonado
authors.forename: Eugen
authors.initials: E
authors.lastname: Boltshauser
authors.forename: Maja
authors.initials: M
authors.lastname: Steinlin
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D020201:Brain Hemorrhage, Traumatic / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D002531:Cerebellum / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult