December 22, 2021
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According to the results of a cross-sectional study published in Neurology, age at pediatric stroke has a significant impact on stroke recovery and affects long-term cognitive outcome regardless of lesion size and lesion location.
“Brain insults during a critical period of cognitive development likely lead to a worse cognitive outcome compared to brain injuries that occur before or after the onset of cognitive function,” Stephanie Abgottspon, MSc, from the Department of Pediatrics at the University Hospital of Bern in Switzerland, and colleagues wrote. In addition, cognitive functions, especially executive functions, are strongly associated with quality of life, academic achievement and social competence, highlighting the importance of monitoring cognitive outcomes after stroke.
“In the present study, we aimed to investigate long-term cognitive outcome after chronic phase pediatric stroke (older than 2 years post-stroke) and to examine whether age at stroke affects cognition to identify patients who at risk for poor cognitive skills.” result,” they added.
Researchers compared the outcomes of 52 patients (median age, 15.3 years) in the chronic phase of stroke with a previous diagnosis of neonatal or childhood arterial ischemic stroke with those of 49 healthy controls (median age, 13.6 years). They excluded people with active epilepsy, severe learning disabilities, or behavioral problems that interfered with cognitive assessment. Using neuropsychological tests, they examined different cognitive domains, such as intelligence, executive function, processing speed, memory, letter fluency and visual-motor skills. Furthermore, Abgottspon and colleagues compared long-term cognitive outcomes in patients after neonatal stroke (between 0 and 28 days), early childhood stroke (between 29 days and less than 6 years), and late childhood stroke (between 6 years and 6 years). . under 16 years old).
Patients in the pediatric stroke group had a significantly worse cognitive outcome compared to the control group. Researchers noted a nonlinear effect of age at stroke, regardless of lesion size and lesion location, for cognitive flexibility, processing speed, and verbal learning with stroke in early childhood, demonstrating a significantly worse cognitive outcome compared to neonatal or late childhood.
“These results suggest that early childhood is a particularly vulnerable developmental period for long-term negative cognitive outcome in pediatric stroke survivors, regardless of lesion size and lesion location,” Abgottspon and colleagues wrote. “Children after early childhood stroke should be closely monitored and provided with adequate treatment and rehabilitation options tailored to their age at stroke and current developmental period to prevent cognitive consequences and improve cognitive outcome.”
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