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Long-term sequelae after acquired pediatric hemorrhagic cerebellar lesions

Wingeier, Kevin ; Bigi, Sandra ; El-Koussy, Marwan ; Heinks-Maldonado, Theda ; Boltshauser, Eugen ; Steinlin, Maja

In: Child's Nervous System, 2011, vol. 27, no. 6, p. 923-931

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    Title
    • Long-term sequelae after acquired pediatric hemorrhagic cerebellar lesions
    Author
    • Wingeier, Kevin. Department of Pediatric Neurology (J212), University Children's Hospital, Inselspital, 3010, Bern, Switzerland
    • Bigi, Sandra. Department of Pediatric Neurology (J212), University Children's Hospital, Inselspital, 3010, Bern, Switzerland
    • El-Koussy, Marwan. Diagnostic and Interventional Neuroradiology, University Hospital, Inselspital, Bern, Switzerland
    • Heinks-Maldonado, Theda. Department of Pediatric Neurology (J212), University Children's Hospital, Inselspital, 3010, Bern, Switzerland
    • Boltshauser, Eugen. Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
    • Steinlin, Maja. Department of Pediatric Neurology (J212), University Children's Hospital, Inselspital, 3010, Bern, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:319338
    Summary
    Purpose: The aim of the present study was to assess cognitive, affective, and motor long-term sequelae after acquired focal pediatric cerebellar lesions. Methods: Eight patients with a history of isolated acquired hemorrhagic cerebellar lesions before the age of 13 participated in this study. All participants underwent a neurologic examination, including the Zurich Neuromotor Assessment (ZNA) and the International Cooperative Ataxia Rating Scale (ICARS). Cognitive functions have been evaluated with a general cognitive assessment and an extensive neuropsychological battery. Furthermore, patients and parents filled in questionnaires about quality of life and possible behavioral or emotional problems. Results: The results revealed that all patients exhibited motor problems (ZNA). Most participants had further restricted oculomotor movements (ICARS). Age at injury and the full scale IQ were significantly positively correlated (Pearson correlation 0.779; p = 0.023). Conversely, no overall neuropsychological profile could be identified except for marginally reduced reaction times and susceptibility to interference. In addition, borderline results in semantic and phonemic word fluency tasks were apparent. A dysexecutive syndrome was diagnosed in one patient. However, verbal performance and reading abilities were non-pathologic in all participants. The patients reported having a good quality of life without major physical restrictions. Conclusions: Emotional disturbances and the presence of a mild cerebellar cognitive affective syndrome (as frequently described in adult patients) could only be confirmed in adolescents with vermis lesions. Nevertheless, in laboratory conditions, neuropsychological impairments were present in all patients. Heterogeneity of age at injury and exact lesion site may have led to interpersonal differences in neuropsychological outcome