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

作者：Kossorotoff Manoelle^*; Gonin Flambois Coralie; Gitiaux Cyril; Quijano Susana; Boddaert Nathalie; Bahi Buisson Nadia; Barnerias Christine; Dulac Olivier; Brunelle Francis; Desguerre Isabelle

来源：Developmental Medicine and Child Neurology, 2010, 52(7): 626-631.

DOI：10.1111/j.1469-8749.2010.03616.x

Aim
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.

• 出版日期2010-7