Article

Previous research investigating outcomes after pediatric intracerebral
hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes.
This study examined cognitive outcomes after spontaneous ICH in school-aged
children with serial assessments over 2 years after stroke. METHOD: Seven
children (age range 6-16y, median 13; six males, one female; 57% white, 43%
black) presenting with spontaneous ICH (six arteriovenous malformations) were
assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke
Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence
Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning,
working memory, and processing speed. RESULTS: PSOM scales showed improved
neurological function over the first 12 months, with mild to no sensorimotor
deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year
sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a
different trajectory; verbal comprehension and perceptual reasoning improved over
24 months; low performance was sustained in processing speed and working memory.
Age-normed centile scores decreased between 1- and 2-year follow-ups for working
memory, suggesting emerging deficits compared with peers. INTERPRETATION: Early
and serial cognitive testing in children with ICH is needed to assess cognitive
functioning and support children in school as they age and cognitive deficits
become more apparent and important for function. WHAT THIS PAPER ADDS: In
children with intracerebral hemorrhage (ICH), motor function improved between 3
months and 24 months. Improvements in cognitive function were variable between 3
months and 24 months. Working memory centiles declined, suggesting emerging
deficits compared with peers. Processing speed improved but remained
significantly below the 50th centile. Cognitive impact of ICH may increase with
age in children.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS