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Hematology 2006
© 2006 The American Society of Hematology

Prevention and Management of Stroke in Sickle Cell Anemia

Orah S. Platt

Correspondence: Orah Platt, MD, Children’s Hospital Boston, 300 Longwood Ave., Bader Building 761, Boston MA 02115-5737; Phone 617-355-6347; Fax 617-730-0383; Email orah.platt{at}childrens.harvard.edu

Abstract

As the overall health of patients with sickle cell anemia (SS) improves and diagnostic techniques become more sensitive, physicians are seeing patients with an increasingly wide range of subtle and not-so-subtle brain injury. The major breakthrough in the field of sickle-related brain injury has been the unprecedented success of transcranial Doppler ultrasonography (TCD) to identify asymptomatic patients at high risk of stroke, coupled with chronic transfusion therapy to prevent it. The evidence for TCD screening and preventive treatment is strong and compelling, but there are still important unanswered questions regarding the implications of "silent infarcts" found in the magnetic resonance images (MRIs) of asymptomatic individuals, and the growing awareness of the burden of neuropsychiatric dysfunction in otherwise apparently healthy individuals.


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Copyright © 2006 by the American Society of Hematology.