Large cerebral vessel disease in sickle cell anaemia

An 18 year old male with documented sickle cell disease was admitted to the hospital for the final time in coma. Cerebral angiography revealed multiple stenotic lesions of the large cerebral vessels. The pathology of this large vessel involvement is demonstrated and the potential contribution of large as opposed to small cerebral vessel disease in the neurological manifestations of sickle cell anaemia is discussed.