Crossed Cerebellar Atrophy in Perinatal Stroke.

Background and Purpose- Perinatal stroke causes most hemiparetic cerebral palsy and lifelong disability. Crossed cerebellar atrophy (CCA) is chronic cerebellar volume loss following contralateral motor pathway injury. We hypothesized that CCA is quantifiable in perinatal stroke and associated with poor motor outcome. Methods- Term-born children with perinatal stroke, magnetic resonance imaging beyond 6 months of age, and no additional neurological disorders were recruited. Blinded scorers measured cerebellar volumes expressed as ratios (contralesional/ipsilesional), with values <1 suggesting CCA. Motor outcomes including perinatal stroke outcome measure (PSOM) motor and cognitive scores (good/poor), Assisting Hand Assessment, and Melbourne Assessment were compared with cerebellar volume measures. Results- Seventy-three children met criteria (53% male). Mean cerebellar ratios were <1.0 (0.975±0.04; range, 0.885-1.079; P<0.001) suggesting occurrence of CCA. Cerebellar ratios did not differ between stroke types or across PSOM motor outcomes. Larger ipsilesional cerebellar volume was associated with poor PSOM cognitive outcome (P=0.042), possibly with poor PSOM motor outcome (P=0.063), and overall PSOM score (P=0.034). Conclusions- CCA occurs in perinatal stroke but is not strongly associated with motor outcome. However, ipsilesional cerebellar volume is associated with poor cognitive and overall outcomes.

Parent's Sense of Coherence and Children's Oral Health-Related Behaviors: Is There an Association?

PURPOSE: Parental capacity to face day-to-day stressors has a relevant role in recognizing and mobilizing resources to control children's oral health behaviors. This capacity has been explored by means of the sense of coherence. The purpose of this study was to explore the association between mothers' sense of coherence (SOC) and their preschool children's oral health-related behaviors. METHODS: Mothers and their pre-school children were recruited during immunization programs at community health centers in Edmonton, Canada. Participants answered eight questions on socio-demographics (covariates), parents' SOC (main independent variable), and children's oral health-related practices (outcome variables). Statistical analyses comprised a two-sample t test, chi-square test, and logistic regression. RESULTS: A total of 378 pairs of mothers/ children participated in this study. Children's mean age was 3.92±(1.33) years. Mothers' SOC was statistically associated with children's frequency of sugar consumption and frequency and pattern of dental visits. The children of mothers who had higher levels of SOC presented a lower frequency intake of food or drink containing sugar and were more likely to visit the dentist for preventive purposes. CONCLUSIONS: Mothers' sense of coherence had a significant association with children's oral health-related behaviors; a higher SOC of mothers was associated with more positive behaviors among their children.