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Cerebrovascular disease in childhood: neuropsychological investigation of 14 cases

Literature shows that studies in the area of neuropsychological research with children who had cerebrovascular accident (CVA) are scarce; however, over the last years there has been a significant increase in studies which take into account neuroradiological and neurosurgerical aspects1.

In the few studies on children development after CVA, neuropsychological deficits are described2-6. Armstrong et al.7 assessed 194 children with sickle cell anemia, amongst whom there were 9 with past history of CVA. These children presented difficulties in linguistic and visual-motor skills, as well as in spatial organization and integration. De Schryver et al.5 found impaired capacity for solving problems in post CVA children, when compared to the general population. Rodrigues et al.8 described children with CVA assed evolutionally by Piaget's clinical method had present a performance significantly inferior when compared to the control group. The sequelae of a CVA during childhood are not yet as widely known as of one during adulthood; however, the more studies there are in the area, the more details shall be discovered, favoring professionals involved in the rehabilitation of such children9.

Based on the neuropsychological theory and specific assessment instruments, this study aimed at drawing up a neuropsychological profile of a group of children with past history of CVA.

Twenty-eight children participated in this study; 14 of them belonged to the experimental group (EG) with both clinical and imaging diagnostic of ischemic CVA. Children with vascular problems related to brain-skull trauma and associated to genetic syndromes were excluded. The other 14 children were placed in the control group (CG), paired according to gender and age to the EG, and besides not having a past history of CVA or another neurological problem, they presented appropriate academic performances. Two public schools of the region of Campinas (Brazil) were chosen by simple random draw, the children were selected by the pedagogue and the teacher, whose criterion was a good performance according to the grade.

The participation of each child in both groups was authorized by parents who agreed with the research by signing a Free Consent Agreement Form approved by the Ethical Committee on research of the Faculdade de Ciências Médicas (FCM) of the Universidade Estadual de Campinas (UNICAMP).

Based on the protocol for neuropsychological research on cerebrovascular disease, the following instruments were used: the medical records of each child from the EG belonging to the Clinical Hospital (CH) of UNICAMP; the Wechsler Intelligence Scale for Children - WISC10; the Visual-Motor Gestalt Test11, the Luria-Nebraska Battery (LNB)12 and the Test of human figure drawing.


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