Spinal cord stroke is a rare but serious condition in the pediatric population, with limited data available. We present a series of 6 pediatric cases to review their clinical presentation, magnetic resonance imaging (MRI) findings, etiology, risk factors, management, and outcomes.

A descriptive analysis was conducted following institutional review board approval, focusing on 6 pediatric patients previously identified by the authors.

The median age at presentation was 10 years, with diverse clinical presentations including back, neck, or shoulder pain and hemiplegia; one patient presented with quadriplegia. MRI findings demonstrated distinct infarction patterns, and thrombophilia evaluations were negative in all cases. Treatment was primarily supportive. Four patients received prophylactic aspirin. Follow-up revealed that 3 patients were ambulatory, whereas 3 exhibited persistent motor deficits, and 2 had a neurogenic bladder.

Spinal stroke in children is rare and often idiopathic, with fibrocartilaginous embolism frequently suggested but rarely confirmed. MRI was crucial for diagnosis, and thrombophilia evaluation is usually recommended in pediatric stroke, including spinal stroke, although no thrombophilia cases were found. Treatment was supportive, with steroids used for suspected inflammation and prophylactic aspirin administered in some cases. Long-term outcomes varied, with some patients experiencing substantial recovery and others showing persistent deficits, highlighting the importance of individualized rehabilitation.