Paediatric Stroke: Diagnostic Strategies and Therapeutic Dilemmas.
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| Title: | Paediatric Stroke: Diagnostic Strategies and Therapeutic Dilemmas. |
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| Authors: | Bieszczad, Dominika1, Barczewska, Magdalena1, Mazurek, Adam2, Popielarska, Kinga, Opalińska-Kubowicz, Marta, Musialska, Zuzanna3, Protsenko, Yuliia4, Kowalska, Marta5, Marczak, Anna, Stadnicka, Olga6, Swojnóg, Marzena bieszczad.dominika@gmail.com |
| Source: | Journal of Education, Health & Sport. 2026, Vol. 87, p1-14. 14p. |
| Subject Terms: | Ischemic stroke, Brain imaging, Diagnosis, Epidemiology, Therapeutics, Symptoms |
| Abstract: | Background. Paediatric arterial ischemic stroke is a potentially disabling neurological condition that remains underrecognized due to its rarity and atypical clinical presentation. Diagnosis in children is often delayed due to heterogeneous clinical presentation and differences in stroke mechanisms compared with adults. Despite advances in neuroimaging and acute reperfusion therapies, evidence-based paediatric-specific diagnostic and treatment strategies remain limited. Aim. The aim of this review was to summarise current evidence regarding the epidemiology, pathophysiology, diagnostic approach, and management of acute ischemic stroke in the paediatric population. Material and methods. A narrative review of the literature was conducted using structured searches of PubMed, Google Scholar, and relevant clinical guideline repositories. Articles published between 2015 and 2025 were considered. The search included original research articles, systematic reviews, meta-analyses, and international clinical guidelines. The review focused on studies addressing risk factors, clinical presentation, neuroimaging techniques, acute treatment, and secondary prevention of paediatric ischemic stroke. Results. Paediatric stroke differs significantly from adult stroke in terms of etiology, clinical features, and outcomes. The most frequent causes include cerebral arteriopathies, congenital heart disease, infections, and haematological disorders, including sickle cell disease. Magnetic resonance imaging remains the diagnostic modality of choice, with diffusion-weighted imaging, arterial spin labelling, and vessel wall imaging improving diagnostic accuracy. Intravenous thrombolysis and mechanical thrombectomy appear feasible and relatively safe in selected paediatric patients; however, high-quality evidence supporting their efficacy is still limited. Conclusion. Paediatric ischemic stroke remains a significant diagnostic and therapeutic challenge. Delayed recognition, heterogeneous underlying mechanisms, and a lack of robust paediatric-specific clinical trials continue to limit optimal management. Further studies are needed to establish evidence-based guidelines, optimize imaging protocols, and refine acute and long-term treatment strategies to improve outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR] |
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| Database: | Education Research Complete |
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