## 5 Discussion  
IS in children is specified as a major neurological emergency, being a primary cause of morbidity and mortality. In the neonatal period, one in 2500-4000 live-born children presents with a stroke, and in children over one month old, 1.2-8 per 100,000 [7]. The data of the given study showed the following distribution: A 24.5% decrease in the primary disability indicator was observed in 2020 (2.1 cases per 100,000 children) compared to 2016 (2.8/100,000). The highest values were recorded in 2017 and 2018 (3.7/100,000), and the trends for the repeated disability indicator were similar. Cases certified in 2020 (11.6/100,000 children) were 23.9% less than in 2016 (15.3/100,000), with the highest level recorded in 2017 (16.9/100,000). Clinical manifestations of IS in children, unlike those in adults, are varied depending on age, and are often obscure, with a variable clinical polymorphism. Also, IS can occur during pregnancy or immediately after birth, without significant symptoms. The mortality rate from pediatric stroke is between 5% and 10%. More than half of survivors have long-term neurological sequelae, and 10-20% suffer from stroke recurrences [7; 9]. These arguments condition the creation of emergency care and rehabilitation centers for pediatric stroke patients, a multidisciplinary approach, highly specialized evaluation and treatment, with significant input from the health care system, families, and the community. According to the WHO classification, stroke can be of several types: transient stroke (TS), which represents ischemia in a localized area of the brain, with motor deficit up to 24 h (from a few minutes to a few hours), without neurological sequelae; involutive stroke, characterized by acute cerebral ischemia with motor deficit for more than 24 h, with its complete involution for 21 days; lacunar stroke--a type of stroke in which blood flow is blocked in a group of very small arteries inside the brain, mainly those that supply blood to \begin{table}
\begin{tabular}{l c c c c c c} \hline \hline \multirow{2}{*}{**Ischemic Foci**} & \multicolumn{3}{c}{**Acute Period**} & \multicolumn{3}{c}{**6 Months Apart**} \\ \cline{2-7}  & **Abs.** & **P, \%** & **II 95\%** & **Abs.** & **P, \%** & **CI 95\%** \\ \hline Norm & - & - & - & 4 & 3.7 & 1.88–5.52 \\ \hline
0.5 \(\times\) 1.0 cm & 5 & 4.6 & 2.58–6.62 & 13 & 12.0 & 8.87–15.13 \\ \hline
1.0 \(\times\) 3.0 cm & 26 & 24.1 & 19.99–28.21 & 31 & 28.7 & 24.35–33.05 \\ \hline
3.0 \(\times\) 5.0 cm & 54 & 50.0 & 45.19–54.81 & 37 & 34.3 & 29.73–38.87 \\ \hline Porencephaly or encephalomalacia & 15 & 13.9 & 10.57–17.23 & 15 & 13.9 & 10.57–17.23 \\ \hline Diffuse encephalomalacia & 8 & 7.4 & 4.88–9.92 & 8 & 7.4 & 4.88–9.92 \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Evolution of the sizes of the ischemic foci detected by MRI in the acute period and six months after IS (abs., %). Figure 9: Percentage rate of the evolution of the sizes of the ischemic foci on MRI six months after IS (%). _Note_. NR—norm, MGF—millimeter gliotic foci (0.5 \(\times\) 1.0 cm), SCF (1 \(\times\) 3 cm)—small cystic formations (1.0 \(\times\) 3.0 cm), MCF (3 \(\times\) 5 cm)—cystic formations of medium size (3.0 \(\times\) 5.0 cm), POR—porencphal cysts larger than 5.0 cm, EM—encephalomalacia with bilateral cystic transformation. deep areas of the brain. In these types of infarctions, cerebral ischemic lesions range from 2 to 20 mm in diameter; IS in evolution is characterized by a slow-progressive evolution, from a few hours to a few days. Clinical symptoms persist for more than three weeks and motor deficit evolves/regresses in about 30 days. In progressive evolution, it can evolve towards established IS--this is a consequence of the neuronal destruction in the damaged vascular territory, which will manifest itself clinically with an installed motor deficit [10]. Each type of stroke requires its specific approach to diagnostics and treatment. For that reason, the study design of this research work included only one type of stroke, ischemic stroke.