Paediatric arterial ischaemic stroke is an important cause of neurological morbidity in children, with consequences including motor disorders, intellectual impairment, and epilepsy. The causes of paediatric arterial ischaemic stroke are unique compared with those associated with stroke in adulthood. The past decade has seen substantial advances in paediatric stroke research and clinical care, but many unanswered questions and controversies remain. Shortage of prospective evidence for the use of recanalisation therapies in patients with paediatric stroke has resulted in little standardisation of disease management. Substantial time delays in diagnosis and treatment continue to challenge best possible care. In this Review, we highlight on some of the most pressing and productive aspects of research in the treatment of arterial ischaemic stroke in children, including epidemiology and cause, rehabilitation, secondary stroke prevention, and treatment updates focusing on advances in hyperacute therapies such as intravenous thrombolysis, mechanical thrombectomy, and critical care. Finally, we provide a future perspective for improving outcomes and quality of life for affected children and their families.

小儿动脉缺血性卒中是儿童神经系统疾病的重要原因，其后果包括运动障碍、智力障碍和癫痫。与成年期卒中相关的病因相比，小儿动脉缺血性卒中的病因是独特的。过去十年，儿科卒中研究和临床护理取得了重大进展，但仍有许多悬而未决的问题和争议。缺乏在儿科卒中患者中使用再通疗法的前瞻性证据导致疾病管理的标准化程度很低。诊断和治疗的大量时间延迟继续挑战最佳护理。在本次审查中，我们重点介绍了儿童动脉缺血性卒中治疗研究中一些最紧迫和最富有成效的方面，包括流行病学和病因、康复、卒中二级预防和治疗更新，重点关注超急性治疗的进展，如静脉溶栓、机械取栓，和重症监护。最后，我们为改善受影响儿童及其家庭的结果和生活质量提供了未来前景。