Cerebral infarction in sickle cell trait

Greenberg, Josh; Massey, E. Wayne

doi:10.1002/ana.410180315

Cited by 29 publications

(10 citation statements)

References 10 publications

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“…However, from the literature it can be appreciated that being a carrier of the sickle cell gene does not increase the risk for anemia (37,38). Although neurological sequelae of the sickle cell trait have been described incidentally, a large study comparing the incidence of neurological abnormalities between carriers and controls revealed no group difference (39,40). In this study, we did not perform an ASL sequence with multiple inversion times.…”

Section: Discussionmentioning

confidence: 99%

Arterial spin labeling measurement of cerebral perfusion in children with sickle cell disease

Gevers

Nederveen

Fijnvandraat

et al. 2011

Magnetic Resonance Imaging

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Purpose: To evaluate the applicability of arterial spin labeling (ASL) cerebral blood flow (CBF) measurements in children with sickle cell disease (SCD). Materials and Methods:We included 12 patients and five controls. Conventional magnetic resonance imaging (MRI) (T2, fluid attenuated inversion recovery [FLAIR], and MR angiography) was performed to diagnose silent infarcts, vasculopathy, or leukoencephalopathy. Pseudo-continuous ASL was performed to measure CBF using two postlabeling delays to identify transit-time effects. Perfusion estimates were corrected for hematocrit and blood velocity in the labeling plane and compared to phase-contrast MR. CBF asymmetries between the flow maps of the left and right internal carotid arteries were tested for significance using paired t-tests. Significant asymmetries were expressed in terms of an asymmetry ratio (AR ¼ absolute difference/mean). An AR >10% was considered clinically relevant.Results: Mean CBF was higher in patients than in controls. Agreement between CBF and flow improved after applying hematocrit and velocity corrections. At a 2100 msec postlabeling delay one patient had a clinically relevant asymmetry. No association was observed between CBF asymmetries and silent infarcts. Conclusion:Care must be taken in the interpretation of ASL-CBF measurements in SCD patients. A long postlabeling delay with blood velocity correction anticipates overestimation of CBF asymmetries.

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Section: Discussionmentioning

confidence: 99%

Arterial spin labeling measurement of cerebral perfusion in children with sickle cell disease

Gevers

Nederveen

Fijnvandraat

et al. 2011

Magnetic Resonance Imaging

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“…The correlation between sickle cell anemia and stroke is well known 6 ; however, increasing evidence suggests the heterozygous carrier state may be associated with thromboembolism 7 , a potential cause of stroke. Additionally, numerous case reports describe stroke in young individuals with SCT, in the absence of traditional risk factors 8–11 . Intrigued by these findings, we conducted a prospective epidemiological investigation of SCT and ischemic stroke, by analyzing a cohort of African Americans followed in the Atherosclerosis Risk in Communities (ARIC) Study.…”

Section: Introductionmentioning

confidence: 99%

Sickle Cell Trait and Incident Ischemic Stroke in the Atherosclerosis Risk in Communities Study

Caughey

Loehr

Key

et al. 2014

Stroke

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Background and Purpose Numerous case reports describe stroke in individuals with sickle cell trait (SCT) in the absence of traditional risk factors for cerebrovascular disease. To date, no prospective epidemiological studies have investigated this association. Methods A population-based sample of African Americans (N=3,497, mean age=54, female=62%) was followed from 1987–2011 in the Atherosclerosis Risk in Communities Study (ARIC), contributing a total of 65,371 person-years. Hazard ratios and incidence rate differences for ischemic stroke were estimated, contrasting SCT to homozygous hemoglobin A (HbAA). Models were adjusted for age, sex, smoking, diabetes, hypertension, total cholesterol, atrial fibrillation, and coronary heart disease. Results SCT was identified in 223 (6.4%) participants. Over a median follow up of 22 years, 401 subjects experienced incident stroke (89% ischemic). Incident ischemic stroke was more frequent among those with SCT (13%) than HbAA (10%). SCT was associated with an ischemic stroke hazard ratio of 1.4 (1.0 – 2.0), and an incidence rate difference amounting to 1.9 (0.4 – 3.8) extra strokes per 1000 person-years. Conclusion We observed an increased risk of ischemic stroke in African Americans with SCT. Further investigation of the incidence and pathophysiology of stroke in SCT patients is warranted.

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“…122 The gene is thought to confer a bene fi cial effect on heterozygotes consisting of a relative resistance to malaria. Sporadic reports exist of stroke in young adults 123 and children 124 with no known risk factors other than sickle cell trait. Children with heterozygous sickle cell trait were found to have parenchymal abnormalities on MRI in 10% and vasculopathy manifesting as tortuosity in 19%.…”

Section: Sickle Cell Traitmentioning

confidence: 97%

Acute Ischaemic Stroke Agnieszka Anna Ardelt

Harrigan

Deveikis

Ardelt

2012

Handbook of Cerebrovascular Disease and Neurointerventional Technique

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This chapter focuses on acute ischaemic stroke: mechanisms, risk factors, clinical presentation, diagnostic evaluation, and treatment other than thrombolysis and thrombectomy, which are discussed in Chap. 9 . The topics are arranged alphabetically. Ischaemic stroke in paediatric patients is discussed separately in an appendix. Acute Ischaemic Stroke: Burden of DiseaseIn the United States, approximately 795,000 people suffer a stroke annually, and the vast majority of strokes are ischaemic in nature. Over 130,000 people with stroke die each year; only cardiac disease, cancer, and chronic lung diseases result in more deaths than stroke.1 Stroke leaves survivors with disabilities which have both personal and societal implications: 20-30% will need assistance with activities of daily living or walking, and the majority will be unable to return to work.

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Cerebral infarction in sickle cell trait

Cited by 29 publications

References 10 publications

Arterial spin labeling measurement of cerebral perfusion in children with sickle cell disease

Arterial spin labeling measurement of cerebral perfusion in children with sickle cell disease

Sickle Cell Trait and Incident Ischemic Stroke in the Atherosclerosis Risk in Communities Study

Acute Ischaemic Stroke Agnieszka Anna Ardelt

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