Silent Strokes May Be Involved in Neurocognitive Impairment in Children With Sickle Cell Disease

Abstract

Neurological complications are frequent occurrences in children and adolescents with sickle cell disease (SCD). This research has investigated the prevalence of neurovascular and neurocognitive impairments in 17 patients with SCD from Northern Brazil, with aged 6-16 years. Transcranial Doppler Ultrasound (TDU) examinations were performed on patients employing the STOP protocol as a risk score to predict stroke. Neuropsychological assessments were also performed: the Wechsler Intelligence Scale for Children - 4th Edition (WISC-IV). Fisher's Exact Test was used for statistical analyses (p ≤0.05) of the collected dataset. Frequent headaches were a common clinical finding, occurring in over 75% of the children. There were no alterations in cerebral hemodynamics on TDU for over 70% of the patients. In general, patients had below-average scores on most cognitive domains. There was a tendency for correlation between transcranial Doppler results and the WISC-IV indices of total Intelligence Quotient (p = 0.069) and Processing Speed Index (p = 0.082). Conclusion: Most SCD patients showed impairments on cognitive tests, but there was no statistically significant correlation between the presence of neurovascular damage and worse performance on the tests.