## 3 Results
This change demonstrated a statistically significant difference over time (Figure 11), comparing the dynamics of the values in the acute period of IS and after six months. In most patients, their VEGF levels reached normal values within six months. However, some children continued to exhibit elevated levels of VEGF, equal to 1705.81 pg/mL during the acute phase of the disease and 792.94 pg/mL in the recovery phase. Persistently high VEGF levels six months post-IS suggest ongoing remodeling and the growth of new vessels in the ischemic focus, indicating active angiogenesis and improved collateral circulation. These processes were particularly intense in children with extensive brain lesions, as  
Figure 11: Mean serum level of VEGF six months after IS in children (pg/mL). Figure 10: Serum VEGF levels six months after IS (pg/mL). evidenced by significantly elevated VEGF levels. These findings underscore the need for pharmacological interventions to regulate these phenomena. No significant correlations were found between the S100B protein and VEGF levels at six months post-IS, either in the main group (r = \(-\)0.088) or the control group (r = 0.195). However, IL-6, VEGF, CNTF, the S100B protein, endoglin (CD105), and APAs play critical roles in promoting mechanisms associated with pediatric IS, including neuroinflammation and blood-brain barrier disruption, which contribute to dysregulated angiogenesis in ischemic areas. The serum levels of IL-6, VEGF, CNTF, S100B, CD105, and APAs are essential biomarkers for pediatric IS. These markers, detectable in peripheral blood, provide insights into the extent of brain tissue damage and long-term neurological prognosis. The study of such reliable biomarkers for IS in children has a vital role in Moldova, as well as worldwide. Over recent decades, there has been an alarming trend in the neuropsychological health of children globally and in the Republic of Moldova. The pediatric morbidity, mortality, and rates of neuropsychological disabilities remain high [9]. DALYs (disease-adjusted life years) in children, frequently accompanied by psychoneurological developmental disorders, are also of significant concern. In children under three years old in the Republic of Moldova, neurological conditions account for 65-70% of morbidity [9]. While the incidence of pediatric stroke is lower than in adults, it has been rising due to improved recognition of the disease, from 2.5 to 2.7 per 100,000 children per year in the 1990s to 10.7 per 100,000 per year by 2002. Stroke is now among the top 10 causes of childhood mortality. However, the issue of DALYs in children remains understudied. Its causes are complex and multifactorial, and the disease often progresses rapidly, rendering earlier research outdated [16]. Ethical and logistical challenges continue to impede further research into the etiology and manifestations of pediatric IS. Moral dilemmas often arise in diagnosing diseases in their early stages. The etiopathogenic factors contributing to DALYs (Disability-Adjusted Life Years) are diverse; in some cases, significant risk factors may be absent from the diagnostic framework [16]. Over the past century, IS emerged as a critical global concern, with imaging modalities becoming indispensable for diagnosis. Pediatric stroke is now recognized as a major neurological emergency and a leading cause of morbidity and mortality. In the neonatal period, stroke occurs in approximately 1 in 2500 to 4000 live-born infants, while in infants older than one month, the incidence is 1.2 to 8 per 100,000 [17]. Unlike in adults, the clinical manifestations of stroke in children are age-dependent, often subtle, and exhibit variable clinical presentations. Stroke may even occur during pregnancy or immediately postpartum without prominent symptoms [18]. The mortality rate for pediatric stroke ranges between 5% and 10%, with over half of survivors experiencing long-term neurological sequelae. Additionally, 10-20% of survivors face stroke recurrence.