Minimal evidence exists about the risk of recurrent childhood acute ischemic stroke in patients subjected to a subsequent head or neck injury. Recurrent or multiple dissections have been demonstrated in select cases. Minor head trauma has also been associated with acute ischemic stroke. The objective of this study was to survey pediatric stroke experts about participation of patients following acute ischemic stroke in high impact, medium impact, and low impact exercise. International Pediatric Stroke Study members were surveyed about athletic participation after stroke. Participants were asked about 2 scenarios: acute ischemic stroke with dissection, and acute ischemic stroke with a negative coagulation work-up and a negative angiogram. In these scenarios, most experts would eventually allow moderate impact sports, with some restrictions. Many experts would not allow high impact sports after a dissection, but disagree about recommendations after idiopathic acute ischemic stroke.