Neuropsychological outcomes following childhood stroke

Childhood stroke is rare but an increasingly recognized cause of childhood disability. Childhood stroke has an incidence rate of 13 per 100, 000 children. Approximately 75% of children have residual functional difficulties following stroke in childhood. A significant number of children experience difficulties in a wide range of neuropsychological domains, and approximately half require extra educational supports due to academic challenges. Following stroke, children’s performance on assessments of general intellectual functioning is often lower than normative population samples or matched controls. Significant impairments are observed in attention, including sustained and divided attention, response inhibition, speed of information processing, and executive functions, including working memory, cognitive flexibility, switching, and emotional regulation. These difficulties in attention and executive function are associated with behavioral and academic challenges for children with stroke. Careful neuropsychological assessment and follow-up is required for children who experience stroke, as some difficulties may only become apparent with increased environmental, cognitive, social, and academic demands over time.