Cerebral Vasculopathy in Children With Sickle Cell Disease in an Amazonian Population

Author:

Alcolumbre Tobelem Felipe Lima1ORCID,de Andrade Guilherme Augusto Lira Ribeiro1ORCID,Paschoal Joelma Karin Sagica Fernandes12,de Oliveira Cardoso Maria do Socorro34,Sarmento Trindade Saide Maria4,Paschoal Eric Homero Albuquerque15,Paschoal-Jr Fernando M.12,Bor-Seng-Shu Edson6

Affiliation:

1. Amazônia Neurovascular Research Group, Federal University of Pará, Belém, Brazil

2. Department of Neurology, Federal University of Pará Medical School, Belém, Brazil

3. Department of Hematology, Federal University of Pará Medical School, Belém, Brazil

4. Foundation Center of Hematology and Hemotherapy of Pará (HEMOPA), Belém, Brazil

5. Department of Neurosurgery, Federal University of Pará, Belém, Brazil

6. Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, São Paulo University Medical School, São Paulo, Brazil

Abstract

Introduction: Sickle cell disease is the most prevalent hereditary disease in the country. The aim of this study was to use transcranial Doppler as a screening method for identifying cerebral vasculopathy in children with sickle cell disease. Methods: An epidemiologic, descriptive, and cross-sectional study was conducted. Patients aged 2-16 years with sickle cell disease and followed at a neurology referral service between January 2014 and March 2020 underwent transcranial Doppler and complementary examinations to screen for cerebral vasculopathy. Results: Screening and confirmatory examinations diagnosed 14 of 164 patients (8.5%) with cerebral vasculopathy. Regarding stroke risk, as measured by cerebral blood flow velocity, 2 of 14 patients (14.2%) were classified as conditional risk (170-199 cm/s) and 12 of 14 (85.7%) as high risk of stroke. Conclusion: Complementary examinations should be performed in all patients with changes on transcranial Doppler to confirm cerebral vasculopathy. Further studies, particularly genetic, are needed to better understand the relationship between sickle cell disease and cerebral vasculopathy.

Publisher

SAGE Publications

Subject

Neurology (clinical),Pediatrics, Perinatology and Child Health

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