Stroke in children with sickle cell disease

Author:

Kirkham Fenella J.,deBaun Michael R.

Publisher

Springer Science and Business Media LLC

Subject

Neurology (clinical)

Reference117 articles.

1. Earley CJ, Kittner SJ, Feeser BR, et al.: Stroke in children and sickle-cell disease. Neurology 1998, 51:169–176.

2. Scothorn DJ, Price C, Schwartz D, et al.: Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke. J Pediatr 2002, 140:348–354. In a multicenter study of patients receiving blood transfusion for at least 5 years after stroke, the recurrence rate was 2.2 per 100 patient years. None of the patients who had had their first stroke in the context of a medical event had a second stroke after 2 years. For the other patients who had had their first strokes without warning, the recurrence rate was 1.9 per 100 patient years. However, vascular imaging to confirm or exclude moyamoya was not available.

3. Ohene-Frempong K, Weiner SJ, Sleeper LA, et al.: Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood 1998, 91:288–294. Ischemic stroke was more common children and older patients and the risk factors were previous transient ischemic attack, low haemoglobin, recent chest crisis, and hypertension. Intracranial hemorrhage occurred mainly in young adults and the risk factors were low haemoglobin and high leukocyte count.

4. Adams RJ, McKie VC, Carl EM, et al.: Long-term stroke risk in children with sickle cell disease screened with transcranial Doppler. Ann Neurol 1997, 42:699–704.

5. Adams RJ: Prevention of stroke by transfusion in sickle cell disease. N Engl J Med 1998, 339:5–11. This randomized controlled trial study of blood transfusion for patients with transcranial Doppler internal carotid or middle cerebral artery velocities greater than 200 cm per sec showed a 92% reduction in the risk of stroke in the treatment arm. However, 10 of 63 patients in the treatment arm dropped out mostly because of alloimmunization or poor compliance.

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