Review the different causes of juvenile stroke, illustrating the hallmark imaging findings. Explore the role of advanced imaging in diagnosing and characterizing juvenile stroke, including underlying vascular abnormalities and potential causes. Analyze the impact of radiological advancements in improving the accuracy and timeliness of juvenile stroke diagnosis.

The incidence of ischemic infarction is rising among adolescents and young adults, emerging as a public health concern, due to significant morbidity and extended disability in this age group.Modifiable risk factors are responsible for nearly 80% of ischemic strokes in young individuals, with cardioembolic stroke being the most common.Prompt and accurate diagnosis is paramount for optimal outcomes. Imaging is critical for characterizing stroke subtypes, identifying underlying causes, and assessing vascular abnormalities, guiding subsequent management.

1. Imaging techniquesImaging algorithms must cover hemorrhage exclusion, assess stroke mimics, and consider eligibility for intra-arterial therapy. CT: the gold standard in the acute setting enabling hemorrhagic stroke exclusion and early ischemic change detection. MRI: higher sensitivity with faster acquisition times. MRI protocols with DWI, gradient-echo, FLAIR sequences, MR angiography, and post-contrast perfusion, can be performed in 6-15’. CT/MRI angiography: provides rapid and precise vascular interpretation. Venous imaging must be included in young adults. Perfusion images: crucial in juvenile stroke, aiding in selecting candidates for...

A multidisciplinary approach involving radiologists and clinicians is imperative in managing juvenile stroke ensuring timely intervention and optimal care.Radiologists must acquaint themselves with the diverse causes of juvenile stroke to guide an accurate imaging workup. This facilitates early identification, determination of underlying etiology, and assessment of vascular involvement, all of which are critical for tailoring therapeutic strategies and I mproving long-term prognosis.

A. Berasategui Criado: Nothing to disclose M. Arroyo Olmedo: Nothing to disclose C. Cantolla Nates: Nothing to disclose S. M. Bretos Azcona: Nothing to disclose A. Somoano: Nothing to disclose S. Revuelta Gómez: Nothing to disclose R. Sutil: Nothing to disclose A. S. Gabín: Nothing to disclose D. Castanedo Vázquez: Nothing to disclose

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