title: Strokes in children: a systematic review.
abstract: BACKGROUND
  Pediatric strokes lead to significant morbidity and mortality. To date, no systematic review has been available to guide the initial diagnostic approach to pediatric stroke.
  
  
  OBJECTIVE
  The objective of this review was to elucidate the current data regarding etiologies of stroke in children and then develop an initial diagnostic evaluation for the pediatric patient presenting to the emergency department with a stroke.
  
  
  METHODS
  Using the PubMed engine, the MEDLINE database was searched using the Preferred Reporting Items in Systematic Reviews and Meta-Analyses guidelines.
  
  
  METHODS
  The inclusion and exclusion criteria were established a priori. Studies must have extractable data regarding first strokes in pediatric patients with clear diagnostic categories.
  
  
  METHODS
  A standardized tool was developed to extract demographic data and stroke etiologies.
  
  
  RESULTS
  Twelve studies were found that met the inclusion criteria. From these studies, a total of 1455 children aged between 21 days and 20 years were available to assess the etiologies of stroke.
  
  
  CONCLUSIONS
  In pediatric patients, the etiologies of stroke are varied and differ for children with ischemic stroke versus hemorrhagic stroke. With the present systematic review, a guide to the initial evaluation of stroke is presented.
authors.affiliation: From the *Children's Hospital at Montefiore, New York, NY and †Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA.
authors.forename: Lindsey Barst
authors.initials: LB
authors.lastname: Gumer
authors.forename: Michael
authors.initials: M
authors.lastname: Del Vecchio
authors.forename: Stephen
authors.initials: S
authors.lastname: Aronoff
mesh_terms: D000293:Adolescent; D002545:Brain Ischemia / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002648:Child; D006801:Humans; D007223:Infant; D010372:Pediatrics; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*