Stroke is an important complication of sickle cell disease. Stroke prediction is clinically important because it offers the possibility of primary prevention. In 1992, transcranial Doppler (TCD) evidence of elevated intracranial internal carotid or middle cerebral artery velocity was demonstrated to be associated strongly with an increased risk of ischemic stroke. This study extends the original study and includes 125 more children, longer follow-up, and intracranial hemorrhage in the stroke-risk model. Elevated time averaged mean maximum blood flow velocity, especially when velocity is 200 cm/sec or greater by TCD, was associated strongly with stroke risk. The cases not predicted by TCD point to the need for more information on the optimal timing of TCD surveillance for stroke risk.

References

1 Powars ER, Wilson B, Imbus C, et al. The natural history of stroke in sickle cell disease. Am J Med 1978; 65: 461–471
10.1016/0002-9343(78)90772-6
CAS PubMed Web of Science® Google Scholar
2 Adams RJ, Nichols FT. Sickle cell anemia, sickle cell trait and thalassemia. In: PJ Vinken, GW Bruyn, HL Klawans, eds. Handbook of clinical neurology, vascular diseases III. Netherlands: Amsterdam Elsevier, 1989: 503–515
Google Scholar
3 Greer M, Scotland D. Abnormal hemoglobin as a cause of neurologic disease. Neurology 1962; 12: 114–123
10.1212/WNL.12.2.114
PubMed Web of Science® Google Scholar
4 Portnoy BA, Herion JC. Neurologic manifestations in sickle cell disease. Ann Intern Med 1972; 76: 643–652
10.7326/0003-4819-76-4-643
CAS PubMed Web of Science® Google Scholar
5 Pavlakis SG. Neurologic complications of sickle cell disease. Adv Pediatr 1989; 36: 247–276
CAS PubMed Google Scholar
6 Bridgers WH. Cerebral vascular disease accompanying sickle cell anemia. Am J Pathol 1939; 15: 353–361
CAS PubMed Web of Science® Google Scholar
7 Stockman JA, Nigro MA, Mishkin MM, Oski FA: Occlusion of large cerebral vessels in sickle cell anemia. N Engl J Med 1972; 287: 846–849
10.1056/NEJM197210262871703
CAS PubMed Web of Science® Google Scholar
8 Rothman SM, Fulling KH, Nelson JS, et al. Sickle cell anemia and central nervous system infarction: a neuropathological study. Ann Neurol 1986; 20: 684–690
10.1002/ana.410200606
CAS PubMed Web of Science® Google Scholar
9 Aaslid R, Markwalder TM, Nornes H. Non-invasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982; 57: 769–774
10.3171/jns.1982.57.6.0769
CAS PubMed Web of Science® Google Scholar
10 Adams RJ, McKie V, Nichols FT, et al. The use of transcranial ultrasonography to predict stroke in sickle cell disease. N Engl J Med 1992; 326: 605–610
10.1056/NEJM199202273260905
CAS PubMed Web of Science® Google Scholar
11 Adams RJ, Brambilla D, for the STOP Investigators. Stroke Prevention Trial in sickle cell anemia (STOP). Proceedings of the 21st Annual Meeting of the National Sickle Cell Disease Program, Mobile, AL, 1996, p 19.
Google Scholar
12 Adams RJ, Litaker M, Nichols FT. Anemia and sickle cell disease. In: V Babikian, L Wechsler, eds. Transcranial Doppler ultrasonography. Philadelphia: Dekker-Mosby 1993: 160–171
Google Scholar
13 Bisse E, Abraham A, Stallings M, et al. High-performance liquid chromatographic separation and quantification of glycosylated hemoglobin A2 as an alternate index of glycemic control. J Chromatogr 1986; 374: 259–269
10.1016/S0378-4347(00)83281-8
CAS PubMed Web of Science® Google Scholar
14 Bisse E, Wieland H. High performance liquid chromatographic separation of human hemoglobins. Simultaneous quantification of foetal and glucated hemoglobins. J Chromatogr 1988; 434: 95–110
10.1016/0378-4347(88)80065-3
CAS PubMed Web of Science® Google Scholar
15 Cox DR, Oakes D. Analysis of survival data. New York: Chapman and Hall, 1984
Google Scholar
16 Frempong KO. Stroke in sickle cell disease: Demographic, clinical and therapeutic considerations. Semin Hematol 1991; 28: 213–219
PubMed Web of Science® Google Scholar
17 Balkaran B, Char G, Morris JS, et al. Stroke in a cohort of patients with homozygous sickle cell disease. J Pediatr 1992; 120: 360–366
10.1016/S0022-3476(05)80897-2
CAS PubMed Web of Science® Google Scholar
18 Powars DR, Chan L, Schroeder WA. β^s-Gene-cluster haplotypes in sickle cell anemia: clinical implications. Am J Pediatr Hematol Oncol 1990; 12: 367–374
10.1097/00043426-199023000-00022
CAS PubMed Web of Science® Google Scholar
19 Adams RJ, Kutlar A, McKie VC, et al. Alpha thalassemia and stroke risk in sickle cell anemia. Am J Hematol 1994; 45: 279–282
10.1002/ajh.2830450402
CAS PubMed Web of Science® Google Scholar
20 Kugler S, Anderson B, Cross D, et al. Abnormal cranial magnetic resonance imaging scans in sickle cell disease: neurological correlates and clinical implications. Arch Neurol 1993; 50: 629–635
10.1001/archneur.1993.00540060059019
PubMed Web of Science® Google Scholar
21 Adams RJ, Nichols FT, Figueroa R, et al. Transcranial Doppler correlation with cerebral angiography in sickle cell disease. Stroke 1992; 23: 1073–1077
10.1161/01.STR.23.8.1073
CAS PubMed Web of Science® Google Scholar
22 Seibert J, Miller S, Kirby R, et al. Cerebrovascular disease in symptomatic and asymptomatic patients with sickle cell anemia: screening with duplex transcranial Doppler US—correlation with MR imaging and MR angiography. Radiology 1993; 189: 457–466
10.1148/radiology.189.2.8105505
PubMed Web of Science® Google Scholar
23 Verlhac S, Bernaudin F, Tortrat D, et al. Detection of cerebrovascular disease in patients with sickle cell disease using transcranial Doppler sonography: correlation with MRI, MRA, and conventional angiography. Pediatr Radiol 1995; 25: S14–S19
PubMed Web of Science® Google Scholar

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Volume42, Issue5

November 1997

Pages 699-704

Long-term stroke risk in children with sickle cell disease screened with transcranial doppler

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Long-term stroke risk in children with sickle cell disease screened with transcranial doppler

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