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Long-term
sequelae in children after cerebellar astrocytoma surgery
F.
K. Aarsen, MA, H. R. Van Dongen, PhD, P. F. Paquier, PhD, M. Van
Mourik, PhD and C. E. Catsman-Berrevoets, MD PhD
Department
of Child Neurology (F.K. Aarsen, and Drs. Van Dongen and
Catsman-Berrevoets), Department of Pediatric Oncology and Hematology
(F.K. Aarsen), Erasmus MC/Sophia Children’s Hospital, Rotterdam, The
Netherlands; Department of Neurology (Dr. Paquier), University
Hospital Erasme (ULB), Brussels; Department of ENT Surgery (Dr.
Paquier), University of Antwerp (UA), School of Medicine; Department
of Linguistics (Dr. Paquier), Free University of Brussels (VUB/ULB),
Belgium; and Department of Medical Psychology (Dr. van Mourik),
Hospital Walcheren, Vlissingen, The Netherlands. Address
correspondence and reprint requests to F.K. Aarsen, Pediatric
Neuropsychologist, Department of Pediatric Neurology, Erasmus
MC/Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The
Netherlands; e-mail: f.aarsen@erasmusmc.nl
. Received
March 24, 2003. Accepted in final form December 23, 2003.
Objective.
To study long-term effects on neurologic, neuropsychological, and
behavioral functioning in children treated for cerebellar pilocytic
astrocytoma (CPA) without additional radio- and chemotherapy.
Methods.
The authors assessed speech, language, nonverbal intelligence, attention,
memory, executive skills, and visual (-spatial) functions in
a consecutive series of 23 children.
Neurologic and neuropsychological follow-up ranged
from 1 year to 8 years and 10 months after resection.
Results.
Long-term sequelae in the investigated domains were found
in all children.
Apraxia, motor neglect, and dysarthric features, as
well as language, sustained attention, visual-spatial, executive,
memory, and behavioral problems, were observed in various
combinations and to different degrees.
No clear pattern of neurocognitive disturbances could
be discerned in this group.
In addition, significant relationships were revealed between
severity of preoperative hydrocephalus and visual-spatial
skills.
The high percentage of children who needed special education
reflects the severity of the impairments.
Conclusion.
Despite the current opinion of a good quality of life after
CPA treatment, careful long-term neurocognitive follow-up is
needed in order to inform parents and teachers about the behavioral
and cognitive sequelae and to contribute to timely social
and educational intervention.
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