## 1 Introduction  
Stroke has a significant impact on morbidity and mortality rates in children [1]. Ischemic stroke (IS) most often occurs in the prenatal period and the first 28 days after birth with a frequency of 1:4000 live newborns [2]. Risk factors and clinical manifestations of stroke in children and adolescents differ from those in adults. The etiological factors of pediatric stroke involve neonatal encephalopathies, anomalies in the development of cerebral vessels (most often, arteriovenous anomalies), hereditary or acquired prothrombotic conditions, hereditary abnormalities of blood vessels in the frame of several genetic syndromes, etc. [3]. In young children, stroke is accompanied by motor, speech, and sensory disorders. In addition, stroke can occur during pregnancy or immediately after childbirth, without any severe symptoms. Sometimes, newborns who suffer stroke present mild or no clinical symptoms until the age of 4-8 months, whereas seizures or paralysis are recorded in some cases. As a result, many children are at risk of not receiving adequate treatment. The pathology leads to a high degree of disability, even resulting in death in 12% of cases, and in 70% of cases, it causes a persistent neurological deficit [4].  
Pediatric stroke includes three subtypes: ischemic stroke (defined as sudden focal infarction, diagnosed by neuroimaging or autopsy, which can lead to arterial stroke, the most common type of stroke, after sudden arterial occlusion--50% of cases), cavernous sinus thrombosis (CVST, which is a venous infarction following a superficial and deep venous thrombosis, associated with severe complications in 1:4 cases) and hemorrhagic stroke (characterized by a spontaneous rupture of a cerebral vessel, commonly in small arteries, cerebral aneurysm, or cerebral arteriovenous malformations) [5]. Some clinicians report that stroke in children occurs in about 50% of cases, others describe a higher incidence of stroke with up to 67-85% of cases [6]. Rapid and accurate diagnosis of stroke is vital, and the therapeutic approach differs depending on the type of pediatric stroke.  
Children present different clinical manifestations of ischemic stroke compared with those of adults, since they are not clear, showing a variable clinical polymorphism depending on the child's age. Thus, it is difficult to diagnose stroke, especially in the first six hours after the onset of the disease. Only 30% of children with cardiovascular disease will present any of the clinical manifestations confirmed by imaging findings during the effective therapeutic time [7]. Young children may have atypical manifestations, while older children have neurological symptoms similar to those found in adults. Older children, besides the neurological symptoms of hemiparesis, aphasia, and hemianopia, might experience headaches and convulsive seizures in 30% of cases, recorded in 20-48% of patients. The presence of nonspecific and variable neurological symptoms requires an investigation of all acute onset cases in young children to exclude the risk of possible ischemic stroke; thus, brain imaging should be recommended in each case [8]. Regarding all those facts mentioned above, the necessity of elaboration of algorithms which would include all signs, even minor signs, emerges to aid in the right indication for prompt imaging, aiming to define the diagnosis of IS as early as possible.  
The planned outcome of this study is the elaboration of algorithms for timely newborn stroke recognition and algorithms for predicting stroke in children. The algorithm's elaboration is based on the results of the given study.