Article

Posterior fossa strokes account for about 10% of ischaemic strokes in
children. Although motor and dysautonomic symptoms are common, to our knowledge
cognitive and affective deficits have not been described in the paediatric
literature. Our aim, therefore, was to describe these symptoms and deficits.
METHOD: In a retrospective study, we included all cases of posterior fossa
strokes in children occurring at a single centre between 2005 and 2007, and
investigated cognitive and affective deficits. RESULTS: Five males aged 3 to 14
years met the inclusion criteria. They all presented very early with mood
disturbances: outbursts of laughter and/or crying and alternating agitation or
prostration that disappeared spontaneously within a few days. Persistent
cognitive deficits were also diagnosed in all five: initial mutism, then anomia,
followed by comprehension deficiency and deficiencies of planning ability,
visual-spatial organization, and attention. Despite early and intensive
rehabilitation, recovery from these cognitive deficits was slow and sometimes
incomplete, and on follow-up they proved to be more disabling than the motor
symptoms. INTERPRETATION: These findings are similar to the cerebellar cognitive
affective syndrome described in adults, and quite similar to the language and
affective deficits observed in children after surgery for posterior fossa tumour.
This is consistent with the role of the cerebellum and brainstem in affective and
cognitive processes from early development.

Langue : ANGLAIS