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Long-term impact of benign external hydrocephalus (BEH) on cognition is largely unknown, and indication for neurosurgical CSF diversion procedure is debated. This study reports neuropsychological and psychosocial function in operated and non-operated BEH children.Eighty-six children (76 males) between 8 and 18 years (mean 13.9) diagnosed with BEH before 12 months were included, of whom 30.2 % were operated. Participants completed neuropsychological tests and questionnaires covering quality of life (PedsQL) and executive function (BRIEF).Both operated and non-operated BEH children performed significantly below normative means on several neuropsychological tests. The children scored themselves higher than the norm average on PedsQL; however, the parents reported life quality comparable to other children. Operated children performed poorer compared with non-operated children on tests of psychomotor speed, attention span, executive function, motor speed and coordination, and on the BRIEF subscale Monitoring. Operated children, but not their parents, reported more problems on PedsQL subscale School than non-operated children.Children with BEH display long-term subtle neurocognitive difficulties. Non-operated children performed significantly better on some neuropsychological measures and reported less psychosocial problems. This difference may be caused by a selection bias: neurosurgical intervention was more likely in children with clinically more pronounced symptoms.

QOS-42. QUALITY OF SURVIVAL AFTER BRAIN TUMOUR IN CHILDHOOD. DATA FROM A PSYCHOSOCIAL AND NEUROPSYCHOLOGICAL FOLLOW UP PROGRAM Torhild Berntsen1, Anne-Britt Skarbo1, Antia Puhr1, Kristine Stadskleiv1, and Stein Andersson2; Oslo University Hospital, Oslo, Norway; University of Oslo, Oslo, Norway AIM: To investigate the impact on quality of life (QoL) of medical complications, adjuvant treatment, cognitive function, gender and age at diagnosis 5 or more years after the initial treatment for brain tumour in childhood. MATERIALS AND METHODS: 66 children were included, 41 girls and 25 boys, 43 with benign and 23 with malignant tumours. All have completed a comprehensive neuropsychological and psychosocial evaluation 5 years after end of treatment, included answering the questionnaire Pediatric Quality of Life Inventory (PedsQL), both children and parents. RESULTS: Children who had benign tumours, but who had medical complications after the initial operation (SC), reported significantly (p , 0.05) more problemscompared to thosewhohadanoperationonly (SO), onall PedsQLdimensions. Children who had adjuvant treatment (SA) reported significantly (p , 0.05) more problems compared to children who had surgery only on the physical, social, and school dimensions, but not on the emotional dimension on PedsQL. No significant differences were found between the groups with medical complications and adjuvant treatment. The parents’ ratings on PedsQL did not differ significantly from the children’s. There were no significant differences between the three groups with regards to IQ, age at diagnosis and gender. CONCLUSION: Having a childhood benign tumour that needs medical treatment after the operation, has a significant impact on quality of life, long after treatment is completed, equal to having a malignant tumour needing adjuvant treatment. Factors as IQ, gender and age at diagnosis are less influential. Neuro-Oncology 18:iii145–iii158, 2016. doi:10.1093/neuonc/now081.42 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Background Serious heart and pulmonary failure may be treated with extracorporeal membrane oxygenation (ECMO). The aim of this follow-up study was a multimodal assessment of outcome in children surviving ECMO at our hospital from 1991 to 2004. Methods Twenty-two children were, on average, 1.18 years old (SD = 1.92; range, 0.1 to 7.8) when ECMO was initiated. Average age at follow-up was 7.2 years (range, 1.8 to 13.9). Thirteen children were treated for cardiac and nine for pulmonary failure. Venoarterial ECMO was performed in 21 patients and venovenous ECMO in one patient. The protocol included a review of patients records, clinical, neurologic and neuropsychologic, and radiological examinations, electroencephalogram, and interviews with the parents. Results Moderate or severe impairment in at least two clinical assessments were found in 16 (72.7%) children. Five (22.7%) children had cerebral palsy and 15 (68.2%) had moderate or severe cognitive impairment. Eight (36%) children had pathological radiologic findings. Pathological electroencephalograms were found in 11 (50%) patients including four (18.2%) with epileptic activity. Children with radiologic findings had a slightly worse cognitive outcome. There was no association between the neurophysiologic findings and the neuropsycohologic performance or the radiologic findings. Based on parental assessment, only four children had pathological scores. Conclusions All children, except for two, came walking to the follow-up visit. All parents were positive to the ECMO treatment, and reported a good or slightly reduced quality of life for their child. Cerebral sequelae were frequently found in children treated with ECMO. The need for treatment and support should be assessed in order to optimize their physical and psychosocial functioning.

Cerebral palsy (CP) is associated with cognitive impairments, learning difficulties and reduced social participation. Individual assessment is necessary for individually tailored interventions. This paper describes the development of a systematic follow-up programme of cognition, and the challenges of integrating it into the regular follow-up of children with CP. Initiated by the Nordic users‘ organisations, a group of psychologists proposed a protocol of follow-up of cognition in children with CP – the 'CP Cog'. This protocol consists of neuropsychological instruments covering general cognitive functioning, visuospatial and executive functioning. The article presents a natural experiment describing development and implementation of the cognitive protocol in three Scandinavian countries. This introduction illustrates challenges associated with implementation, especially how the success of the protocol hinges on structural backup within the different countries. In conclusion the CP Cog assessment protocol holds the promise of increasing the awareness among habilitation professionals that children with CP are in need of cognitive evaluation and educational support.