REFLECTIONS ON CEREBRAL ISCHEMIC EVENTS IN THE PEDIATRIC POPULATION: AN INTEGRATIVE LITERATURE REVIEW

Abstract

Cerebral ischemic events in the pediatric population are neurological conditions of considerable clinical relevance, linked to a range of etiological factors and to the risk of lasting effects on child development. Although less frequent than cerebrovascular events in adults, they present distinctive features related to age, clinical presentation, predisposing factors, diagnostic work-up, treatment approach and prognosis. This review set out to examine the scientific evidence on cerebral ischemic events in children, addressing etiological and risk factors, clinical manifestations, diagnostic strategies, treatment approaches and the main neurological and functional consequences involved. It consists of an integrative literature review, built around the PICo strategy and carried out by searching for studies on cerebral ischemia, ischemic stroke and the pediatric population. The evidence gathered shows that ischemic cerebral events in childhood have a multifactorial origin, involving arteriopathies, cardiac disease, hematological conditions, infectious and inflammatory processes, coagulation disorders and other predisposing factors. Clinical presentation can vary according to age, the vascular territory affected and the extent of the lesion, a circumstance that may delay diagnostic recognition. Neuroimaging holds a central place in confirming ischemia and investigating its cause, while treatment options depend on the clinical picture and the underlying mechanism. Despite progress in the management of pediatric stroke, gaps remain in early recognition and in the standardization of treatment strategies tailored to children. The review concludes that pediatric cerebral ischemia calls for a high level of clinical suspicion, an individualized etiological work-up, a multidisciplinary approach and long-term follow-up, given its potential motor, cognitive, behavioral and functional consequences.