The Use of Transcranial Ultrasonography to Predict Stroke in Sickle Cell Disease

Adams, Robert J.; McKie, Virgil; Nichols, Fenwick T.; Carl, Elizabeth; Zhang, Dao Long; McKie, Kathleen T.; Figueroa, Ramón; Litaker, Mark S.; Thompson, William O.; Hess, David C.

doi:10.1056/nejm199202273260905

Cited by 566 publications

(443 citation statements)

References 25 publications

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“…Recent advances in detection of risk with transcranial Doppler have made primary prevention of stroke a high priority in children with SCD. 118,119 The risk of stroke during childhood is Ϸ1% per year, but patients with transcranial Doppler evidence of high cerebral blood flow velocity rates (time-averaged mean velocity of Ն200 cm/s) have stroke rates in excess of 10% per year.…”

Section: Sickle Cell Diseasementioning

confidence: 99%

Primary Prevention of Ischemic Stroke

Goldstein¹,

Adams²,

Becker³

et al. 2001

Circulation

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401

196

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Section: Sickle Cell Diseasementioning

confidence: 99%

Primary Prevention of Ischemic Stroke

Goldstein¹,

Adams²,

Becker³

et al. 2001

Circulation

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401

196

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“…Transcranial Doppler ultrasonography, a non-invasive, well tolerated and cheap investigation can detect intracranial arterial stenosis, and hence identify children with sickle cell disease who are at highest risk for cerebral infarction. Hence it has been suggested that periodic ultrasound examination with selective use of transfusion therapy could make the primary prevention of occlusive stroke insickle cell children an achievable goal (92).…”

Section: Commentsmentioning

confidence: 99%

Epidemiology of Stroke in Blacks in Africa

Osuntokun

1994

Hypertens Res

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I reviewed the literature on epidemiology of Stroke in Blacks in Africa. Stroke, said to be rare in Black Africans some four decades ago, has become increasingly common now accounting for 4% to 9% of deaths and 6.5% to 41% of neurological admissions in hospital populations. In community-based studies, it is the third or fourth commonest non-infective neurological disease, after headache, epilepsy and diseases of peripheral nerves. In both hospitals and communities, males are more afflicted than females. The age specific incidence rates are similar to those found in Caucasians and Japanese. Occlusive stroke is the commonest type accounting for about 60%, followed by cerebral haemorrhage (20%) subarachnoid haemorrhage (10%). The major risk factor is hypertension which is present in 80% or more in patients with cerebral haemorrhage and subarachnoid haemorrhage, and in 60% in those with occlusive stroke. Other risk factors are age, sickle cell disease, diabetes mellitus, non-ischaemic heart disease (including cardiomyopathies, infective endocarditis, atrial fibrillation mitral valve prolapse) infections, arteritis, smoking, alcohol consumption and cocaine use (in the young people), Transient ischaemic attracts are relatively uncommon reflecting the rarity of large vessel atherosclerotic disease. Case fatality rate is higher than in the developed countries. About 15% of young people (below age of 40 years) with stroke have no identifiable risk factor. Studies are needed on the effectiveness of population-based control of hypertension (which afflicts 10% to 30% of African communities) to reduce the incidence of stroke, especially as atherosclerotic ischaemic heart disease, although emerging is still relatively uncommon in Sub-Saharan African communities. (Hypertens Res 1994; 17 Suppl. I: S1-S10)

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“…[1][2][3][4] Although hydroxyurea therapy and chronic red blood cell transfusion may decrease the complications of chronic organ damage, 5,6 both treatment modalities require long-term compliance to prevent irreversible end-organ damage. Currently, however, hematopoietic stem cell transplantation (HCT) provides the only cure for SCD.…”

Section: Introductionmentioning

confidence: 99%