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Although less common than in adults, stroke is the sixth leading cause of death in children, affecting ~2–13 children per 100,000 under 18 years of age. Because it is underappreciated clinically, the diagnosis of pediatric stroke is often delayed or even missed, or misdiagnosed as more common conditions such as migraine, epilepsy, or viral illnesses. Since pediatric stroke is caused by unique etiologies and can present differently than in adults, diagnostic imaging should be tailored to the specific and diverse causative entities and distinctive needs of the pediatric population. This chapter provides a comprehensive review of pediatric stroke, including the etiologies, diagnosis, and management, emphasizing the role of neuroimaging in diagnostic and treatment pathways. Understanding the distinct clinical entity of pediatric stroke and the role of imaging in diagnosis is important for early detection and treatment of this underappreciated disease.
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