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Neuropediatrics 2006; 37(1): 13-19
DOI: 10.1055/s-2006-923932
Original Article

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
  • 1University Children's Hospital Berne, Switzerland
  • 2University Children's Hospital Bale, Switzerland
  • 3University Children's Hospital Geneva, Switzerland
  • 4University Children's Hospital Lausanne, Switzerland
  • 5University Children's Hospital Zürich, Switzerland
  • 6Children's Hospital Aarau, Switzerland
  • 7Children's Hospital Bellinzona, Switzerland
  • 8Children's Hospital Chur, Switzerland
  • 9Children's Hospital Lucerne, Switzerland
  • 10Children's Hospital Neuchatel, Switzerland
  • 11Children's Hospital St. Gallen, Switzerland
  • 12Children's Hospital Sion, Switzerland
Further Information

Publication History

Received: September 6, 2005

Accepted after Revision: January 25, 2006

Publication Date:
15 March 2006 (online)

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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

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MD Julia Pavlovic

University Children's Hospital
Inselspital

3010 Bern

Switzerland

Phone: + 41316329424

Fax: + 41 316 32 95 00

Email: julia.pavlovic@insel.ch