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Updated: Jun 23, 2026
Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Late emergence of cognitive deficits after unilateral neonatal stroke
Robyn Westmacott1, Daune MacGregor, Rand Askalan
1Department of Pediatrics, Hospital for Sick Children, 555 University Avenue, Toronto ON M5G 1X8, Canada. robyn.westmacott@sickkids.ca
Insights
Children with neonatal stroke show emerging cognitive deficits in school, particularly in working memory and processing speed. Males are at higher risk, highlighting the need for ongoing monitoring beyond early childhood.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Psychology
Background:
- Neonatal arterial ischemic stroke (AIS) impacts many children annually.
- Long-term neuropsychological outcomes of neonatal AIS remain poorly understood.
Purpose of the Study:
- To longitudinally assess the long-term neuropsychological implications of unilateral neonatal AIS.
- To identify emerging cognitive deficits in school-aged children with a history of neonatal stroke.
Main Methods:
- Longitudinal study of 26 children with unilateral neonatal AIS.
- Age-appropriate Wechsler scales administered at preschool and school-age.
- Comparison of patient performance with normative data and between time points.
Main Results:
- Preschoolers showed no significant cognitive differences from norms.
- School-aged children exhibited lower Full Scale IQ, Working Memory, and Processing Speed.
- Significant decline in Full Scale IQ noted from preschool to school age, with 69% showing deficits.
Conclusions:
- Children with unilateral neonatal stroke face increased risk for higher-level cognitive skill deficits during school years.
- Males appear particularly vulnerable to these emerging deficits.
- Continued monitoring is crucial, even for those without early apparent deficits.
Background And Purpose:
Neonatal arterial ischemic stroke (AIS) affects a surprisingly large number of children each year, yet little is known about the long-term neuropsychological implications.
Methods:
Using age-appropriate Wechsler scales of intellectual ability, this longitudinal study examined 26 children with a history of acutely diagnosed unilateral neonatal AIS as preschoolers (3 years 6 months to 5 years 11 months) and again as grade-school students (6 years 1 month to 12 years 5 months), and contrasted performance with the normative sample of the test.
Results:
As preschoolers, patients' performance did not differ from the normative sample for Full Scale IQ, Verbal IQ, or Performance IQ, and there were no significant differences associated with infarct laterality. As school-age children, performance was significantly lower than the normative sample for Full Scale IQ Working Memory and Processing Speed, but not for Verbal IQ or Performance IQ. Contrasts between Time 1 and Time 2 revealed a significant decline in Full Scale IQ, which reflected emerging deficits in nonverbal reasoning, working memory, and processing speed. Individual subject analyses revealed that 69% of the children showed significant declines in 1 or more IQ index measures. We found no significant differences in cognitive performance associated with lesion laterality, though males performed more poorly than females on several cognitive measures at Time 2.
Conclusions:
These findings suggest that children with unilateral neonatal stroke, particularly males, are at increased risk for emerging deficits in higher-level cognitive skills during the school years. Continued follow-up of these children is needed, even those with no apparent deficits as toddlers or preschoolers.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
01:15Ischemic Stroke ll: Pathophysiology