From Acute Events to Chronic Burden: A 16-Year Single-Center Experience in Pediatric Cerebrovascular Diseases

Abstract

Objective: Childhood cerebrovascular diseases (CVDs) comprise a heterogeneous group of disorders associated with significant neurological morbidity and long-term functional impairment. Despite increasing awareness, epidemiological and outcome data in pediatric populations remain limited. This study aimed to evaluate the demographic characteristics, etiological distribution, clinical presentation, neuroimaging findings, treatment approaches, and long-term outcomes of pediatric patients diagnosed with CVD in a tertiary pediatric neurology center. Methods: This retrospective single-center study included 25 pediatric patients diagnosed with CVD and followed up between 2010 and 2026. Demographic data, clinical findings, etiological factors, neuroimaging characteristics, treatment strategies, and follow-up outcomes were retrospectively reviewed. Functional outcomes were assessed using the Modified Rankin Scale (mRS). Results: The mean age at diagnosis was 8.4 years, and 60% of patients were male. Ischemic stroke was identified in 68% of patients, whereas 32% had hemorrhagic stroke. Hematologic/thrombophilic disorders and vasculopathies represented the most common etiological subgroups. Acute-onset hemiparesis, headache, and seizures were the leading presenting symptoms. Neuroimaging abnormalities were detected in all patients, with multiple lesions observed in 68% and bilateral involvement in 44% of cases. Pediatric intensive care unit admission was significantly more frequent among patients with hemorrhagic stroke (P < .001), and was significantly associated with long-term neurological sequelae development (P = .004). Long-term neurological sequelae were identified in 60% of patients, and post-stroke epilepsy developed in 52%. Mortality was 4%, while the median mRS score at the last follow-up visit was 2. Conclusion: Pediatric CVDs are associated with substantial long-term neurological burden despite relatively low mortality rates. Hemorrhagic events were linked to more severe clinical outcomes and higher intensive care requirements. Early recognition, comprehensive neurovascular imaging, and multidisciplinary long-term follow-up are essential for improving neurological outcomes in affected children.   Cite this article as: Sengenc E, Tunc A, Guler S, et al. From acute events to chronic burden: a 16-year single-center experience in pediatric cerebrovascular diseases. Cerrahpaşa Med J 2026, 50, 0098, doi: 10.5152/cjm.2026.26098.