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Pediatric Stroke

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Physician's Field Guide to Neuropsychology

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Abstract

Arterial ischemic stroke (AIS) occurs when there is a disruption of arterial blood supply to the brain, causing focal injury in a vascular territory. It is one of the leading causes of acquired brain injury in the pediatric population. The increased plasticity of the young brain has traditionally been thought to protect against significant neurological and neuropsychological deficits (Woods and Teuber, Trans Am Neurol Assoc 98:113–117, 1973). In fact, a significant amount of research highlights the vulnerability of the young brain and the widespread, long-term neuropsychological deficits that often result from early disruption of brain function and subsequent brain development. An increasing body of work indicates that children with a history of neonatal and childhood stroke are at increased risk for difficulties in a number of neurological, cognitive, academic, and psychosocial domains that emerge over the course of development. Heterogeneity in outcomes within the pediatric stroke population has been linked to a range of clinical and demographic factors, including those related to the brain (e.g., lesion location, size, and volume), the child (e.g., age at stroke, age at assessment, co-occurring neurological conditions, stroke etiology, genetic predispositions), and the environment (family stress/functioning, parent mental health, sibling interactions, educational support, rehabilitation therapy). Our understanding of how these factors interact to impact neuropsychological outcome and resiliency is far from complete, but evidence to date suggests that these relationships are very complex. This chapter details a case of childhood stroke, assessed through multiple neuropsychological assessments across development. The case highlights the unique cognitive and psychosocial difficulties that emerge across development following early childhood stroke and the importance of long-term follow-up and team collaboration in this population.

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Authors and Affiliations

  1. Children’s Stroke Program, Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Robyn Westmacott

  2. Psychology Department, The Hospital for Sick Children, Toronto, ON, Canada

    Robyn Westmacott

  3. Psychology Department, York University, Toronto, ON, Canada

    Jordana Waxman

  4. Children’s Stroke Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada

    Nomazulu Dlamini

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  1. Robyn Westmacott
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Correspondence to Robyn Westmacott .

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Editors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Karen M. Sanders

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Westmacott, R., Waxman, J., Dlamini, N. (2019). Pediatric Stroke. In: Sanders, K. (eds) Physician's Field Guide to Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8722-1_9

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