## 4 Discussion
VEGF is expressed when angiogenesis is upregulated, as seen in the embryonic neuroectoderm, glioblastomas, and around infarcts, whereas it is expressed at low levels in the absence of angiogenesis, such as in the adult neuroectoderm. Additionally, the induction of angiogenesis through growth factors (pro-angiogenesis) could be a rational therapy for IS patients [38]. VEGF is important in branched morphogenesis. Data presented by [PERSON], [PERSON] et al. support the idea that the collateral density and vascular branching are closely linked [39]. Few studies have analyzed whether endogenous VEGFmediates collateral growth. It is suggested that VEGF acting through VEGFR-1 mediates collateral remodeling. This contrasts with the role of VEGFR-1 as a VEGF inhibitor during development [39; 40; 41]. Other research indicates that measuring VEGFR-1 signaling is challenging due to its weak kinase activity [40]. However, it has been found that VEGF expression determines the collateral density in secondary tissues, and high VEGF levels contribute to collateral formation in the embryo. In our clinical study on children with IS, we found that the VEGF levels in the acute phase of the disease were significantly higher in the study group than in the control group, which is consistent with the findings of other experimental and clinical studies. Acute ischemic stroke (AIS) is a heterogeneous disease, and the elevated levels of the studied biomarkers showed varied results correlated with the severity of the ischemic lesion [40]. The ischemic focus can be identified using brain MRI, while the assessment of certain immunological biomarkers can provide insights into the mechanisms and severity of AIS, a finding strongly supported by the results of our study. Thus, patients with severe AIS, characterized by pronounced neurological symptoms, exhibited significantly elevated levels of S100B, VEGF, CNTF, IL-6, and APAs, along with decreased CD105 levels. In contrast, in mild to moderate AIS cases, these values fluctuated, showing slight to moderate abnormal increases. Although the primary goal of studying AIS biomarkers is to assess their correlation with the disease severity, as well as the size and topography of the ischemic lesion detected on MRI scans, further research is necessary to evaluate their role in optimizing treatment strategies for improving both early and long-term neurological outcomes. The application of tests for endoglin (CD105), S100B, APAs, IL-6, CNTF, and VEGF significantly enhances diagnostic accuracy, helps determine the disease severity, and predicts the long-term neurological outcomes. The likelihood of detecting neurological issues increases with an excessive rise in certain biomarkers and a decline in others, underscoring the need for early therapeutic intervention in all patients suspected of having AIS. Prediction also regards certain bioethics issues that should be taken in account, especially in the case of prediction in child care [42]. Artificial intelligence (AI) tools, such as chatbots (ChatGPT, DeepSeek, Claude, Meta AI, Zapier Agents), search engines (Perplexity, Google AI Overviews, Arc Search), content creation (Jasper, Anyword, Writer), video creation and editing (Runway, Descript, Wondershare Filmora), image generation (DALL-E 3, Midjourney, Ideogram), knowledge management and AI grounding (Mem, Notion AI Q&A, Personal AI), task and project management (Asana, Any.do, BeeDone), etc., have been asserting themselves, in recent years, as elements in pediatric diagnostics that can change traditional emphases. Thus, AI is currently associated with a series of important challenges, with new perspectives and obstacles but also involving new possibilities and new opportunities. Since its inception, AI has been thought of and developed more as a substitute and replacement for human expertise in all spheres of life, but also to make the decision-making and approval process more rational.