## 5 Discussion
In fact, in all cases where there was minimal suspicion of stroke, IS was diagnosed using CT and MRI. Identifying the minimal but relevant clinical signs for IS based on the age of the children can serve as the right indications for CT and MRI. The mathematical analysis yielded the following results:(1) newborns: epileptic seizures, disturbance of consciousness, generalized motor disorders, and apnea attacks; (2) infants: decreased strength in one half of the body, preferential use of one hand, focal epileptic seizures, and impaired consciousness; (3) young children: decreased strength in one side of the body, focal movement impairment, focal epileptic seizures, speech disorder, and disorder of consciousness; (4) children older than three years: weakness on one side of the body, headache, sensory disturbances, and psychomotor agitation, and focal epileptic seizures. IS in both the middle cerebral artery system and the posterior cerebral artery system may manifest as seizures of one half of the body, whereas stroke in the middle cerebral artery system may manifest as seizures of the hand and face only. Seizures isolated to one leg can be found in neonatal IS with localization in the anterior cerebral artery system, and those isolated to the upper extremities are characteristic of the involvement of the posterior part of the middle cerebral artery. Authors [PERSON] and [PERSON] mention that in cases of an involvement of the middle cerebral artery, atypical convulsions are observed (hiccupping, eye blinking, gaze fixation, chewing, sucking, vertical nystagmus, and thumb addiction) [16], such convulsions being rarely isolated. Apnea attacks or cyanotic attacks, probably of an epileptic nature, have been reported. Strokes, regardless of age of onset, can be hemorrhagic (subarachnoid or intraparenchymal) or ischemic. The type of stroke varies depending on the age of the patient and the etiology, which is different in the child than in the adult. More than 70 potential risk factors for stroke in children and adults are described. Often, however, ischemia is the result of nonatherosclerotic vasculopathy, cardiac embolisms, or coagulability disorders. In children, stroke can occur as a result of congenital heart diseases, acquired heart diseases, infectious or inflammatory diseases, vascular disorders, hematological diseases, cerebrovascular malformations, or brain trauma; however, for a third of strokes, the etiology remains undetermined [17; 18]. The incidence of ischemic stroke (IS) in children is increasing due to the advancement of imaging techniques for diagnosing the disease. Imaging studies help in identifying the type and location of IS, as well as in making a differential diagnosis. According to the data from a specific study, medium-sized ischemic areas are more common in neonates (52.1%) compared to pediatric patients (46%), while larger areas are predominant in the pediatric group (29.7%), especially in infants and young children. The middle cerebral artery (51.0%) and the anterior cerebral artery (40.7%) are the main arteries involved in the ischemic process across all age groups, with a higher prevalence in neonates and infants. The posterior cerebral artery (8.3%) is more frequently involved in older children (16.7%). The left hemisphere is more commonly affected (72.2%) compared to the right (27.8%), and a diffuse distribution of the pathological focus was found in 27.8% of cases, with a higher prevalence in infants (38.5%) and newborns (32.4%). These findings align with existing literature data. The study's strength lies in its correlation of clinical signs relevant to IS prognosis with paraclinical results. Strong correlations were found between imaging and clinical data (rxy = 0.983), which facilitated the development of a clinical-etiological classification of IS in children based on age. This formed the basis for the algorithm development and its inclusion in protocols. These newly developed algorithms led to the standardization of imaging protocols in pediatric centers for stroke patients.