Pediatric Stroke in a United Arab Emirates (UAE) Tertiary Care Center: A Retrospective Descriptive Study.

BACKGROUND: Pediatric stroke is a rare, serious neurological emergency with evolving management paradigms. Data from the United Arab Emirates (UAE) remains limited. OBJECTIVE: To describe the clinical presentation, radiological findings, etiologies, and management patterns of pediatric stroke, with special focus on eligibility for specialized acute interventions such as mechanical thrombectomy. METHODS: This retrospective review analyzed pediatric patients below 16 years of age diagnosed with stroke and admitted or evaluated between January 2000 and January 2025. RESULTS: 19 pediatric stroke cases were included and classified based on neuroimaging findings. Most patients were male (78.9%), with a mean age at onset of 6.8 years. Arterial ischemic stroke was the most prevalent (89.5%) compared to venous and hemorrhagic strokes. Among the identified etiologies, moyamoya disease (47.4%) is the most common etiology, followed by cardiac disorders (26.3%). Clinical presentation varied by age group. Motor weakness (69.2%) was the most common initial manifestation in childhood and adolescent groups, whereas focal seizures were most common (80%) in neonatal stroke. Brain magnetic resonance imaging (MRI) was the primary imaging modality. Middle cerebral artery (MCA) territory involvement (76.5%) and left-sided strokes (58.8%) were most frequent. Multifocal infarcts and hemorrhagic transformations were observed in 29.4% and 17.6%, respectively. No patient received t-PA; despite the availability of mechanical thrombectomy (MT), only one patient underwent the procedure, although five patients (26%) met eligibility criteria for MT. CONCLUSION: While imaging and clinical features aligned with global trends, advanced intervention utilization remained limited. These findings highlight the need for earlier recognition, standardized diagnostic protocols, and improved access to specialized stroke therapies to enhance timely management in pediatric cases.