Original Article	Neuropediatrics 2006; 37: 13-19 DOI: 10.1055/s-2006-923932
Georg Thieme Verlag KG Stuttgart · New York
Neuropsychological Problems after Paediatric Stroke: Two Year Follow-Up of Swiss Children
J. Pavlovic1, F. Kaufmann1, E. Boltshauser5, A. Capone Mori6, D. Gubser Mercati10, C.-A. Haenggeli3, E. Keller8, J. Lütschg2, J.-P. Marcoz12, G.-P. Ramelli7, E. Roulet Perez4, T. Schmitt-Mechelke9, M. Weissert11, M. Steinlin1
1 University Children's Hospital Berne, Switzerland 2 University Children's Hospital Bale, Switzerland 3 University Children's Hospital Geneva, Switzerland 4 University Children's Hospital Lausanne, Switzerland 5 University Children's Hospital Zürich, Switzerland 6 Children's Hospital Aarau, Switzerland 7 Children's Hospital Bellinzona, Switzerland 8 Children's Hospital Chur, Switzerland 9 Children's Hospital Lucerne, Switzerland 10 Children's Hospital Neuchatel, Switzerland 11 Children's Hospital St. Gallen, Switzerland 12 Children's Hospital Sion, Switzerland

Abstract

Aim: 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. Conclusion: 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.

Key words

Paediatric stroke - cognitive outcome