Unseen struggles: a narrative review of psychosocial and family outcomes following pediatric stroke

Abstract

Pediatric stroke results in complex sequelae that extend beyond motor and cognitive impairments to include significant psychological and psychosocial challenges for both affected children and their families. This narrative review synthesized peer-reviewed studies published in English between 2000 and November 2025, identified through searches in PubMed and Web of Science using keywords related to pediatric stroke and psychosocial outcomes. Eligible studies examined psychological, social, and family-related outcomes, and findings were integrated through a narrative synthesis due to substantial methodological heterogeneity. Internalizing symptoms-such as anxiety, depression, and post-traumatic stress disorder-commonly emerge and may persist long-term, even in cases of favorable neurological recovery. Parental psychological distress, particularly maternal anxiety, depression, and sense of guilt, together with family functioning, are closely associated with children's emotional and behavioral adjustment, reflecting a bidirectional relationship between caregiver and child wellbeing. Recovery after pediatric stroke should be conceptualized as a comprehensive process, requiring a multidisciplinary, family-centered framework incorporating psychological support that addresses not only motor and cognitive deficits but also emotional and psychosocial challenges. Future research and clinical efforts should focus on the development and implementation of accessible, empirically validated interventions aimed at enhancing resilience and long-term quality of life for patients and their families.