Abstract: Background：The incidence of stroke in children has increased significantly in recent years and arterial ischemic stroke is the most common one. The causes of ischemic stroke in children are different from those in adults. Early recognition and timely treatment can significantly reduce the disability rate. Objective：To analyze the etiology, clinical features, imaging characteristics, treatment and prognosis of ischemic stroke in children in order to provide reference to early diagnosis. Design：Case series report. Methods：The clinical data of 50 children with arterial ischemic stroke who were hospitalized in Beijing Tiantan Hospital Affiliated to the Capital Medical University from April 2017 to July 2019 were analyzed retrospectively. Main outcome measures：Etiology and clinical manifestations of arterial ischemic stroke in children. Results：There were 29 boys and 21 girls with mean onset age of 8.8±3.9 years (9 months to 17 years old). The peak incidence was in children aged 7 to 10 years (21 cases, 42%). Etiology included moyamoya disease(78%), infection (10%), trauma(6%), vascular disease(2%), cardiac disease(2%). One case had no identifiable cause. The most frequent clinical manifestation was hemiplegia (94%). Abnormal feeling and language disorder were found in 9 cases(18%), respectively. Other neurological manifestations included central facial paralysis, disturbance of consciousness and epilepsy. Neuroimaging results showed that the cerebral infarction was located in multiple lobes for 19 cases (38%), basal ganglia for 15 cases (30%), single lobes for 10 cases (20%) , brain stem for 1 case (2%) , and multiple lesions (basal ganglia, lobe, cerebellum and brainstem) for 5 cases (10%). Digital subtraction angiography (DSA) showed that anterior circulation was involved in 34 cases with 23 of middle cerebral artery stenosis or occlusion. Conclusion：The peak onset of arterial ischemic stroke in children occurred in school age. Hemiplegia is the most common neurological manifestation. Moyamoya disease and infection were the main causes of stroke in this group. Anterior circulation is more easily involved than posterior circulation and ischemic infarction is the most common in the middle cerebral artery blood supply area.

Key words: Ischemic stroke, Etiology, Children