Cerebrovascular disease in childhood: neuropsychological investigation of 14 cases

Abstract

-There are few studies about the development of a child after a cerebrovascular accident (CVA), and they usually describe problems such as diminishing in intellectual capacities, difficulties in linguistic and visual-motor skills, as well as in spatial organization and integration. In this study, there were 28 children participating, being 14 placed in the experimental group (EG) after clinical diagnosis and ischemic CVA imaging, and other 14 children without past history of CVA, who formed the control group (CG). The neuropsychological research protocol included an intelligence test, a visual-motor coordination test, human figure drawing, a cortical functions battery and the medical records of the children from the EG. The analysis of the results of this study revealed that the best performances after the CVA are related to the shortest time of functional recovery; CG presented better performances than EG in all the instruments used, in cognitive, perceptual and motor skills. It has been noticed that CVA may lead to intellectual reduction in case of a recurrence of the vascular insult.KEY WORDS: cerebrovascular disease, childhood, neuropsycological investigation. Doença cerebrovascular na infância: investigação neuropsicológica em 14 casosRESUMO -Nos poucos estudos acerca do desenvolvimento da criança após o acidente vascular cerebral (AVC) são descritos problemas como rebaixamento intelectual, dificuldades na capacidade lingüística, visomotora, na organização e integração espacial. Neste estudo fizeram parte 28 crianças, sendo 14 pertencentes ao grupo experimental (GE) com diagnóstico clínico e de imagem de AVC isquêmico. Outras 14 crianças sem história de AVC que formaram o grupo controle (GC). O protocolo de investigação neuropsicológica constou de teste de inteligência, teste de coordenação viso-motor, desenho da figura humana, bateria de funções corticais e prontuário médico das crianças do GE. A análise dos resultados deste estudo mostrou que os melhores desempenhos após o AVC, estão relacionados ao menor tempo de recuperação funcional; houve desempenho superior do GC sobre o GE em todos os instrumentos utilizados, nas áreas cognitiva, perceptual e motora. Constatou-se ainda que o AVC pode levar a rebaixamento intelectual, quando ocorre um quadro de repetição do insulto vascular. PALAVRAS-CHAVE: doença cerebrovascular, infância, avaliação neuropsicológica.Literature shows that studies in the area of neuropsychological research with children who had cerebrovascular accident (CVA) are scarce; however, over the last years there has been a significant increase in studies which take into account neuroradiological and neurosurgerical aspects 1 . In the few studies on children development after CVA, neuropsychological deficits are described 2-6 . Armstrong et al.7 assessed 194 children with sickle cell anemia, amongst whom there were 9 with past history of CVA. These children presented difficulties in linguistic and visual-motor skills, as well as in spatial organization and integration. De Schryver et ...

Neuropsychological outcome following childhood stroke – a review

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“…90,91 Recurrence rates are high, justifying early diagnosis and primary or secondary preventative measures to reduce these complications. No standard treatment schemes have yet been proposed for managing stroke in children, with the majority of data having been drawn from consensus by specialists or extrapolated from reports in the literature on adult patients.…”