Factors affecting cognitive outcome in early pediatric stroke.
OBJECTIVE
We examined cognitive performance in children after stroke to study the influence of age at stroke, seizures, lesion characteristics, neurologic impairment (NI), and functional outcome on cognitive outcome.


METHODS
This was a prospectively designed study conducted in 99 children who sustained an arterial ischemic stroke (AIS) between the age of 1 month and 16 years. All children underwent cognitive and neurologic follow-up examination sessions 2 years after the insult. Cognitive development was assessed with age-appropriate instruments.


RESULTS
Although mean cognitive performance was in the lower normative range, we found poorer results in subtests measuring visuoconstructive skills, short-term memory, and processing speed. Risk factors for negative cognitive outcome were young age at stroke, seizures, combined lesion location (cortical and subcortical), as well as marked NI.


CONCLUSIONS
We recommend that all children with a history of AIS undergo regularly scheduled neuropsychological assessment to ensure implementation of appropriate interventions and environmental adjustments as early as possible.
From University Children's Hospital Berne (M. Studer, E.W., T.H., M. Steinlin); Center for Cognition, Learning and Memory (M. Studer, T.H., M. Steinlin), University of Berne; University Children's Hospital Zürich (E.B., A.H.); Children's Hospital Aarau (A.C.M.); University Children's Hospital Basel (A.D.); University Children's Hospital Geneva (J.F.); Children's Hospital Neuchâtel (D.M.); Children's Hospital Chur (E.K.); Children's Hospital St. Gallen (O.M.); Children's Hospital Sion (J.-P.M.); Children's Hospital Bellinzona (G.-P.R.); University Children's Hospital Lausanne (C.P.); Children's Hospital Winterthur (R.S.); and Children's Hospital Lucerne (T.S.-M.), Switzerland.
Martina
M
Studer
Eugen
E
Boltshauser
Andrea
A
Capone Mori
Alexandre
A
Datta
Joel
J
Fluss
Danielle
D
Mercati
Annette
A
Hackenberg
Elmar
E
Keller
Oliver
O
Maier
Jean-Pierre
JP
Marcoz
Gian-Paolo
GP
Ramelli
Claudia
C
Poloni
Regula
R
Schmid
Thomas
T
Schmitt-Mechelke
Edith
E
Wehrli
Theda
T
Heinks
Maja
M
Steinlin
D000293:Adolescent; D002545:Brain Ischemia / Q000150:complications / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000523:psychology*