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A cognitive and affective pattern in posterior fossa strokes in children: a case series

Manoelle Kossorotoff1, Coralie Gonin-Flambois, Cyril Gitiaux

  • 1Paediatric Neurology Department, Hôpital Necker-Enfants Malades, APHP, 149 rue de Sévres, Paris, France. manoelle.kossorotoff@nck.aphp.fr

Developmental Medicine and Child Neurology
|April 8, 2010
PubMed

Insights

Pediatric posterior fossa strokes can cause significant cognitive and affective deficits, impacting children more than motor symptoms. Early identification and rehabilitation are crucial for managing these long-term challenges.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Developmental Psychology

Background:

  • Posterior fossa strokes represent approximately 10% of ischemic strokes in children.
  • While motor and dysautonomic symptoms are recognized, cognitive and affective deficits remain under-described in pediatric literature.

Purpose of the Study:

  • To describe the cognitive and affective deficits associated with posterior fossa strokes in children.
  • To investigate the long-term impact of these deficits on recovery and quality of life.

Main Methods:

  • Retrospective study of pediatric posterior fossa stroke cases between 2005 and 2007.
  • Inclusion of all male patients aged 3-14 years meeting stroke criteria.
  • Assessment of cognitive and affective symptoms and deficits.

Main Results:

  • All five included patients presented with early mood disturbances (e.g., excessive laughter/crying, agitation).
  • Persistent cognitive deficits were observed in all patients, including mutism, anomia, comprehension difficulties, and impaired planning, visual-spatial organization, and attention.
  • Cognitive deficits were more disabling than motor symptoms, with slow and sometimes incomplete recovery despite intensive rehabilitation.

Conclusions:

  • Findings align with the cerebellar cognitive affective syndrome observed in adults.
  • Results suggest a significant role for the cerebellum and brainstem in pediatric affective and cognitive development.
  • The study highlights the need for comprehensive assessment and management of cognitive and affective symptoms in pediatric posterior fossa stroke.
Abstract

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