Related Experiment Video
Updated: Jun 10, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Stroke in Children with Sickle Cell Disease
Fenella J. Kirkham1, Michael R. DeBaun
1Department of Pediatrics, Washington University School of Medicine, 4444 Forest Park Boulevard, St. Louis, MO 63108, USA. F.Kirkham@ich.ucl.ac.uk
Current Treatment Options in Neurology
|July 29, 2004
Summary
Children with sickle cell disease face high stroke risks. Prompt treatment includes oxygen, blood transfusions, and specific therapies to manage central nervous system complications and prevent recurrence.
Area of Science:
- Neurology
- Pediatrics
- Hematology
Background:
- Children with sickle cell disease (SCD) are highly susceptible to ischemic stroke and transient ischemic attacks.
- Intracranial arteriopathy is a common cause, affecting major cerebral arteries.
- Central nervous system (CNS) complications also include seizures, coma, sinovenous thrombosis, and demyelination.
Purpose of the Study:
- To outline the immediate management priorities for acute CNS events in pediatric SCD.
- To detail diagnostic modalities for differentiating stroke from other CNS complications.
- To review secondary prevention strategies and emerging treatments for stroke in SCD.
Main Methods:
- Immediate interventions: oxygen supplementation and packed red blood cell transfusion if hemoglobin < 10 g/dL.
- Erythrocytapheresis or exchange transfusion to reduce hemoglobin S < 30%.
- Neuroimaging: CT (hemorrhage exclusion), MRI (T2, MRA, fat-saturated neck, MRV, DWI) for diagnosis.
Main Results:
- Prompt transfusion and hemoglobin S reduction significantly lower stroke risk.
- Specific treatments address CNS complications: anticoagulation for thrombosis, steroids for demyelination, BP management for PRES.
- Regular blood transfusions reduce recurrent stroke risk from ~67% to ~10%.
Conclusions:
- Timely diagnosis and management of acute CNS events are critical in pediatric SCD.
- Aggressive secondary prevention, primarily through regular blood transfusions, is highly effective.
- Ongoing research explores novel primary prophylaxis and management strategies.
More Related Videos
Related Concept Videos
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...