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Introduction: New imaging markers employing sophisticated models of tissue microstructure may lead to better understanding of neurobiological substrates in childhood arterial ischemic stroke.

Methods: Four children with acute unilateral MCA territory ischemic stroke were retrospectively included [two males, age range 2 -16 years]. Parameters of two complementary diffusion modeling techniques: Neurite Orientation Dispersion and Density Imaging (NODDI), and Spherical Mean Technique (SMT) were estimated using two-shell diffusion data acquired at presentation (b- values = 1000 and 3000 s/mm²). For comparison, diffusion tensor imaging (DTI) parameters were also estimated. Parameter estimates were derived from the acute infarct-affected gray matter, the reconstructed pyramidal tract and the contra-hemispheric homologs. Contrast-to-noise ratios (CNRs) were calculated for each pair of homologous brain …