Acute cerebrovascular accident (CVA) is a severe condition in children and adolescents with a high risk of disability. A literature review was carried outon intensive stroke care in children and adolescents using databases such as PubMed, Science Direct, and eLibrary. The search utilized keywords suchas "acute cerebrovascular accident", "stroke", "children", "clinical manifestations", and "intensive care". The review includes sources for the last 10years (2014-2024). The inclusion criteria consisted of descriptions of clinical manifestations and intensive care management for stroke in childhood and adolescence. The exclusion criteria referred to articles on the clinical presentation and treatment of stroke in adult patients. The main factors for stroke in childhood include sickle cell anemia, cardiovascular diseases, cancer pathology, and genetic disorders. The manifestations of stroke in children and adolescents have nonspecific clinical features. There are currently no approved protocols for the treatment of stroke in children, and there are insufficient clinical studies for this condition. Therefore, pediatric practice often extrapolates aspects of intensive care for stroke from the adult population. The type of stroke, such as arterial ischemic stroke (AIS) or hemorrhagic stroke (HS), cerebral venous sinus thrombosis, or stroke due to sickle cell anemia, determines the emergency care required for children. Intensive therapy should be carried out in a pediatric intensive care unit (PICU), focusing on stabilizing vital functions and maintaining optimal cerebral perfusion pressure. Developing specific protocols for intensive stroke treatment in children and adolescents is necessary to improve the quality of emergency care for this patient population