Factors affecting cognitive outcome in early pediatric stroke

Neurology. 2014 Mar 4;82(9):784-92. doi: 10.1212/WNL.0000000000000162. Epub 2014 Jan 31.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain Ischemia / complications
  • Brain Ischemia / psychology*
  • Child
  • Child, Preschool
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology*
  • Cognition*
  • Female
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Memory
  • Neuropsychological Tests
  • Risk Factors
  • Stroke / complications
  • Stroke / psychology*