Department of Pediatrics, University of Tartu, Tartu, Estonia.
Pediatr Neurol. 2011 Feb;44(2):101-9. doi: 10.1016/j.pediatrneurol.2010.08.012.
This study assessed neurocognitive and neurologic outcomes of children with neonatal and childhood strokes. Twenty-one children with neonatal (mean age, 6.86 years) and 10 children with childhood (mean age, 8.21 years) strokes, identified via the Estonian Pediatric Stroke Database (1995-2006), participated. A developmental neuropsychologic assessment was used for neurocognitive outcomes, and the Paediatric Stroke Outcome Measure for neurologic outcomes. Neuromotor impairment was evident in 62% of children with neonatal strokes, and in 70% of children with childhood strokes. Compared with control subjects, children with strokes exhibited worse attention, language, memory, and sensorimotor functions. The sensorimotor domain comprised the most impaired neurocognitive area, whereas executive functions remained intact in both stroke groups. A well-preserved executive function may account for the normal range of intelligence in children with strokes. More severe impairment in neurocognitive skills was evident after neonatal strokes, and the visuospatial domain was more impaired than in children from the childhood group. Prognoses were worse after left hemisphere strokes associated with epilepsy. Our results on emerging neurocognitive deficits in several areas underline the importance of neuropsychologic testing and the follow-up of children with pediatric strokes.
本研究评估了新生儿和儿童期脑卒中患儿的神经认知和神经功能结局。通过爱沙尼亚儿科脑卒中数据库（1995-2006 年）确定了 21 例新生儿（平均年龄 6.86 岁）和 10 例儿童（平均年龄 8.21 岁）脑卒中患儿。使用发育神经心理学评估进行神经认知结局评估，使用儿科脑卒中结局测量量表进行神经功能结局评估。62%的新生儿脑卒中患儿和 70%的儿童脑卒中患儿存在神经运动障碍。与对照组相比，脑卒中患儿的注意力、语言、记忆和感觉运动功能较差。感觉运动域是神经认知领域最受损的区域，而两组脑卒中患儿的执行功能均正常。良好的执行功能可能是脑卒中患儿智力处于正常范围内的原因。新生儿脑卒中后神经认知技能的损害更为严重，且视空间域的损害比儿童组更为严重。与癫痫相关的左半球脑卒中预后更差。我们在多个领域出现的新兴神经认知缺陷的研究结果强调了神经心理学测试和对儿科脑卒中患儿随访的重要性。
