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Aim: Paediatric arterial ischaemic stroke can lead to reduced quality of life (QoL). It is important to identify predictors of QoL to support recovery. We examined long-term QoL after arterial ischaemic stroke concerning different variables.Method: Children registered in the Swiss Neuropediatric Stroke Registry and suffering from arterial ischaemic stroke between 2000 and 2008 were included. Two years post-stroke, assessments included intelligence quotient tests for cognitive impairment and modified Rankin Scale (mRS) for neurological impairment; 5 years post-stroke, the Kidscreen-27 was used for QoL, DSM-IV criteria screening was used for attention deficits, and the ABILHAND-Kids was used for manual motor skills. Age at stroke, sex, socioeconomic status, lesion characteristics, neuropsychological and motor outcome, and mRS were correlated with QoL measures.Results: Seventy children were examined (49 males, 21 females; mean age 7y 2wks). Age at stroke, sex, socioeconomic status, and lesion characteristics did not influence QoL; IQ below average and attention deficits partially influenced QoL. The highest predictive value for QoL was found for manual motor impairment (p=0.002) and mRS scores (p=0.013). Combined motor, cognitive, and attention impairment negatively affected QoL (p=0.001).Interpretation: Neurological and cognitive impairments after paediatric arterial ischaemic stroke negatively influence QoL. Children with motor and neurological problems, as well as those with combined motor, cognitive, and attention problems, are at higher risk for low QoL. [ABSTRACT FROM AUTHOR]

AIMo describe the characteristics of paediatric cerebral sinus venous thrombosis (CSVT) in Switzerland. METHOD: data on clinical features, neuroimaging, risk factors, and treatment were collected for all children in Switzerland younger than 16 years of age who had CSVT between January 2000 and December 2008. A follow-up examination and a cognitive assessment were performed (mean follow-up period 26mo). Differences between neonates and children (patients older than 28d) were assessed and predictors of outcome were determined. RESULTS: twenty-one neonates (14 males, seven females; mean age 9d, SD 8d) and 44 children (30 males, 14 females; mean age 8y 7mo, SD 4y 5mo) were reported. The incidence of paediatric CSVT in Switzerland was 0.558 per 100000 per year. In neonates, the deep venous system was more often involved and parenchymal injuries were more common. The strongest predictor of poor outcome was neonatal age (odds ratio 17.8, 95% confidence interval 0.847-372.353). Most children showed global cognitive abilities within the normal range, but impairments in single cognitive subdomains were frequent. INTERPRETATION: paediatric CSVT is rare. Its outcome is poor in neonates. Most children have good neurological outcomes, but some patients have individual neuropsychological impairments. [ABSTRACT FROM AUTHOR]

Abstract: We report the case of a 10-year-old boy with pharmacoresistant epilepsy, symptomatic of a right temporoparietal hemorrhagic lesion, who displayed an eating passion as described for the gourmand syndrome (GS) in adults and discuss the role of epilepsy in GS. This patient presented with a significant change in his eating habits (abnormal preoccupation with the preparation and eating of fine-quality food) concordant with the onset of his seizure disorder, without any previous history of eating disorders or psychiatric illness. This observation corroborates the important role of the right cerebral hemisphere in disturbed eating habits, including the relatively benign GS, and, possibly rarely, in less benign eating disorders such as anorexia and obesity. [Copyright &y& Elsevier]

Background Assessing nerve traumas in children is challenging. Electrodiagnostic studies are often not tolerated. We tested if ultrasound examination in children with recent supracondylar humerus fracture and ulnar nerve pathology was well tolerated and whether it was helpful in assessing the nerve trauma. Methods This is a retrospective analysis of all pediatric cases with recent supracondylar humerus fracture and persistent ulnar deficits presenting to our neurology outpatients clinic from October 2016 to September 2017. All patients underwent clinical neurological examination. Additional examinations in the form of EMG and nerve ultrasound using a 18 MHz hockey stick probe were proposed as additional investigations. Results Patients were aged 3–10 years (mean age 6.3 years), 4 male and 2 female. All experienced severe extension type supracondylar humerus fractures (Type III and Type IV), treated with closed (3 patients) or open reduction (3 patients) and fixed with crossed pinning (2–4 pins). Ulnar nerve deficits in intrinsic hand muscles ranged from M0 to M3. 3 patients showed complete loss of ulnar sensory motor function. 3 were able to tolerate EMG. All 6 patients tolerated and were able to complete ultrasound examination. In 1 patient with complete loss of function, discontinuity of the nerve with formation of stump neuromas was detected in ultrasound. In the other 5 cases, nerve continuity could be demonstrated, but significant nerve swelling (sulcus to upper arm ratios 1.4–2.7; mean 1.97) was apparent in all. In the 2 most severe cases of nerve swelling, additional nerve compromise with scar tissue was detected. Ultrasound findings led to surgical intervention in 2 cases (in one additional EMG data was available): 1) nerve repair by a sural nerve graft for the case of neuronotmesis and 2) neurolysis followed by anterior displacement in one case with severe nerve swelling and compromising scar tissue. Conclusions Nerve ultrasound is well tolerated in children and proved to be useful and informative for management and counselling. Useful ultrasound indicators of neuronal damage included loss of nerve continuity, neuroma formation, compromising scar tissue and nerve swelling. [ABSTRACT FROM AUTHOR]

Aims Children after pediatric arterial ischemic stroke (AIS) are known to suffer from neurological and neuropsychological impairments but limited data is available concerning quality of life (QoL) outcome. The aim of this present study is to examine long-term effects on QoL in a population-based AIS sample from Switzerland. Methods Children registered in the Swiss Neuropaediatric Stroke Registry (SNPSR) and suffering an AIS during the years 2000–2008 were included. Five years after stroke, children and parents rated QoL with the Kidscreen-27 (Physical Wellbeing, Psychological Wellbeing, Parents/Autonomy, Social Support, and School Environment). QoL and subdomains were related to age at stroke, gender, post-stroke cognitive abilities, socio economic status of parents, and lesion characteristics. Results Concerning the children’s rating, of sixty-nine children (29% female; age at stroke 12.02 years, range: 5–21) only 2.9% reported overall QoL below average. There was no significant correlation between QoL and age at stroke or sex, females had a tendency to report lower QoL. Children with combined lesions (cortical and subcortical) had lower overall QoL. Children with left sided lesions had a tendency of lower QoL. Mann–Whitney U comparison of means showed IQ to be independent of QoL. Altogether, children rated social support as the most impaired subdomain. The parent’s QoL ratings correlated with those of their children (Pearson r = .539, p = .000) but was lower than those of the children, reaching significance in some domains. Conclusions QoL of children after AIS in general is not or mildly disturbed, but parents feel more problems for their children. Social support was for children and parents the most disturbed domain, pointing to marked problems with peers. Combined cerebral lesions were the only significant effect on QoL. These results point to the fact that despite of neurological and neuropsychological problems, these children are well integrated in society, which might be an effect of adequate support by parents, teachers and/or therapeutic interventions. [ABSTRACT FROM AUTHOR]