Pavlovic J, Kaufmann F, Boltshauser E, Capone Mori A, Gubser Mercati D, Haenggeli C-A, Keller E, Lütschg J, Marcoz J-P, Ramelli G-P, Roulet Perez E, Schmitt-Mechelke T, Weissert M, Steinlin M
University Children's Hospital Berne, Switzerland.
Neuropediatrics. 2006 Feb;37(1):13-9. doi: 10.1055/s-2006-923932.
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.
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.
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.
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.
本研究旨在获取以人群为基础的儿童缺血性卒中后神经及认知转归的相关信息。
数据来自瑞士儿童神经病学卒中登记处（SNPSR），时间跨度为2000年1月1日至2002年7月1日，包括儿童（动脉缺血性卒中1型，AIS 1）和新生儿（动脉缺血性卒中2型，AIS 2）。卒中后18至24个月进行随访检查，包括病史、神经及神经心理学评估。
48名儿童中有33名（22名AIS 1，11名AIS 2）参与了研究。33名中的16名神经转归良好。儿童卒中后平均智商水平正常（94），但6名儿童智商<85（50 - 82），75%存在神经心理学问题。由于处理速度方面的问题（89.5），操作智商（93）低于言语智商（101，p = 0.121）；听觉短期记忆尤其受到影响。对学业的影响很常见。右侧梗死患儿的转归较差。儿童中期卒中的患儿预后最佳。转归与病变部位之间无明确关系。新生儿卒中后，11名儿童中有7名发育正常，其余4名出现癫痫提示预后较差。
儿童卒中后约75%的儿童存在神经心理学问题。卒中时年龄较小以及癫痫的出现是预后较差的预测因素。
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