Strokes in children and adolescents, although rare, are serious when they occur. A practical clinical approach is to differentiate between those events that occur in the presence of systemic disease and those that are restricted conditions involving just the intracranial circulation. Division on the basis of the presence or absence of intracranial hemorrhage further narrows down the differential diagnosis and dictates the urgency with which angiography should be performed. Treatment depends on the underlying condition and on the development of seizures, increased intracranial pressure, or subarachnoid hemorrhage. Prognostic statements are difficult and must be highly individualized.
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