For the first time, the 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke include recommendations for interventional treatment in pediatric patients with AIS. Although much work remains to adapt prehospital and hospital stroke protocols for pediatric patients, expert consensus and recent studies highlight the importance of early stroke recognition in children and support the safety and potential benefit of endovascular interventions in select pediatric patients with AIS. These recommendations serve as a foundation for future recommendations and address the phases of pediatric acute stroke care. ✍🏼 @annealexandrov @AlexandraCzap @OanaDumitrascu5Koto @ashupjadhav @BarrowNeuro @SVINjournal @PoojaKhatriMD @wtkimberly @brianmacgrory @tmadsenem @eva_mistry @natperezossa @strokemaven @PSporns @stavtjoumakaris @WFNeurosurgery @shadiyaghi2

Every year in the United States, >600000 individuals have a first ischemic stroke and approximately 200000 more have a recurrent stroke. This guideline aims to incorporate this updated evidence in order to provide an up-to-date, comprehensive set of recommendations for the acute evaluation and management of patients with AIS. ✍🏼 @annealexandrov @AlexandraCzap @OanaDumitrascu5Koto @ashupjadhav @BarrowNeuro @SVINjournal @PoojaKhatriMD @wtkimberly @brianmacgrory @tmadsenem @eva_mistry @natperezossa @strokemaven @PSporns @stavtjoumakaris @WFNeurosurgery @shadiyaghi2

The 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke aims to cover the full course of the emergency evaluation and early management of the patient with AIS. This includes the earliest interaction with the health care system in the prehospital space, early evaluation and treatment, and in-hospital management of patients with AIS. 📷 Journey of a patient with AIS. ✍🏼 @annealexandrov @AlexandraCzap @OanaDumitrascu5Koto @ashupjadhav @BarrowNeuro @SVINjournal @PoojaKhatriMD @wtkimberly @brianmacgrory @tmadsenem @eva_mistry @natperezossa @strokemaven @PSporns @stavtjoumakaris @WFNeurosurgery @shadiyaghi2

Brain imaging is essential to exclude hemorrhage in adult and pediatric patients eligible for AIS reperfusion therapies. Although CT-based protocols are more efficient and generalizable, MRI-based protocols may be appropriate in high-resource settings and in pediatric populations if similar time to imaging can be achieved as with CT. 📷 ASPECTS: Alberta Stroke Program Early CT Score. ✍🏼 @annealexandrov @AlexandraCzap @OanaDumitrascu5Koto @ashupjadhav @BarrowNeuro @SVINjournal @PoojaKhatriMD @wtkimberly @brianmacgrory @tmadsenem @eva_mistry @natperezossa @strokemaven @PSporns @stavtjoumakaris @WFNeurosurgery @shadiyaghi2