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Abstract
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.
GLOSSARY
- AIS=
- arterial ischemic stroke;
- ANOVA=
- analysis of variance;
- BG=
- basal ganglia;
- BSID=
- Bayley Scales of Infant Development;
- FDI=
- freedom from distractibility;
- FSIQ=
- full-scale IQ;
- K-ABC=
- Kaufman Assessment Battery for Children;
- mRS=
- modified Rankin Scale;
- NI=
- neurologic impairment;
- PIQ=
- performance IQ;
- POI=
- perceptual organization index;
- PSI=
- processing speed index;
- SES=
- socioeconomic status;
- VCI=
- verbal comprehension index;
- VIQ=
- verbal IQ;
- WAIS-R=
- Wechsler Adult Intelligence Scale–Revised;
- WISC=
- Wechsler Intelligence Scale for Children;
- WM=
- white matter;
- WMI=
- working memory index
Footnotes
↵* These authors contributed equally to the manuscript.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 742
- Received May 19, 2013.
- Accepted in final form October 23, 2013.
- © 2014 American Academy of Neurology
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