Pediatric stroke: plasticity, vulnerability, and age of lesion onset.

The authors aim to investigate brain plasticity and vulnerability through the study of the relationship of age at the time of brain injury and neurocognitive and psychiatric outcome. Children with early stroke performed more poorly compared with children with late stroke in a wide variety of domains including intellectual function, language, memory, visuospatial function, academic function, and psychiatric problems. The exception to this pattern was that children with late stroke performed more poorly in two of three executive function tests. These findings suggest that in children with focal brain injury, as in those with more diffuse brain insults, younger age at injury predicts worse neurocognitive outcomes, although this may not apply to selected executive function outcomes. Adverse psychiatric outcome after early stroke is less direct but is evident in terms of severity in affected cases.