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Pathophysiology of stroke in sickle cell disease

Cheryl A Hillery1, Julie A Panepinto

  • 1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin 53201-2178, USA. chillery@bcsew.edu

Microcirculation (New York, N.Y. : 1994)
|July 29, 2004
PubMed

Insights

Stroke in sickle cell disease (SCD) impacts motor and cognitive abilities. Pathophysiology involves complex vascular issues, including red cell adhesion and inflammation, contributing to both symptomatic and silent strokes.

Area of Science:

  • Neurology
  • Hematology
  • Vascular Biology

Background:

  • Stroke is a significant complication in sickle cell disease (SCD), affecting both motor and cognitive functions.
  • Symptomatic strokes in SCD are linked to large cerebral artery intimal disease.
  • Silent strokes, often caused by microinfarcts, suggest underlying microvascular disease in SCD patients.

Purpose of the Study:

  • To elucidate the poorly understood pathophysiology of stroke in sickle cell disease.
  • To explore the potential mechanisms contributing to cerebral vasopathology in SCD, considering various vascular injury sites.

Main Methods:

  • Review of existing literature on stroke natural history and pathophysiology in SCD.
  • Analysis of proposed contributing factors to cerebral vasopathology, including cellular and molecular mechanisms.

Main Results:

  • Stroke in SCD affects both motor and cognitive functions.
  • Pathophysiology is complex and likely varies with the site of vascular injury.
  • Potential contributors include red cell adhesion, oxidative stress, inflammation, and coagulation system activation.

Conclusions:

  • The pathophysiology of stroke in sickle cell disease is multifactorial and not fully understood.
  • Understanding these mechanisms is crucial for developing targeted therapies.
  • Cerebral vasopathology in SCD may involve a combination of factors affecting large and small cerebral vessels.

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