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Cerebrovascular Accident in Sickle Cell Anemia

Aka: Cerebrovascular Accident in Sickle Cell Anemia

See Also
1. Sickle Cell Anemia
Epidemiology: Incidence
1. Children: 5% (silent CVA may occur in up to 17%)
2. Lifetime risk: 25%
Pathophysiology
1. Blockage of Internal Carotid Artery
Symptoms: Findings suggestive of acute CVA
1. Behavior change
2. Persistent Headache
Imaging
1. Transcranial doppler Ultrasound
  1. Routine screening starts at age 2 years
  2. Evaluate transcranial blood flow velocity (TBV)
    1. High CVA risk suggested by TBV >200 cm/sec
2. MRI Head or CT Head
  1. Indicated for suspected acute cerebrovascular event
Management: Exchange Transfusions
1. Reduce proportion of Hemoglobin S <50%
2. Maintain this level through childhood
References
1. Adams (1998) N Engl J Med 339:5-11

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook