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Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
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Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow

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Transcranial Doppler ultrasonography in adults with sickle cell disease

N Valadi1, G S Silva, L S Bowman

  • 1Department of Neurology, Medical College of Georgia, 1429 Harper St., HF 1154, Augusta, GA 30912, USA.

Neurology
|August 23, 2006
PubMed

Insights

Transcranial Doppler (TCD) screening for stroke risk in sickle cell disease (SCD) is effective in children but not adults. Adult SCD patients show lower TCD velocities, meaning the criteria used for children are unsuitable for adults.

Area of Science:

  • Neurology
  • Hematology
  • Vascular Medicine

Background:

  • Sickle cell disease (SCD) carries a high risk of stroke, particularly in children.
  • Transcranial Doppler (TCD) is a key tool for identifying children with SCD who require stroke prevention via blood transfusion.
  • The utility of TCD for assessing stroke risk in adult SCD patients remains undetermined.

Purpose of the Study:

  • To investigate the effectiveness of Transcranial Doppler (TCD) in identifying stroke risk in adults with sickle cell disease (SCD).
  • To compare TCD velocities in adults with SCD to those previously reported in children with SCD.
  • To evaluate the impact of age and hematocrit on TCD measurements in adults with SCD.

Main Methods:

  • A study involving 112 adult patients diagnosed with SCD and 53 healthy control subjects.
  • Comparison of TCD velocities between adult SCD patients and healthy controls.
  • Analysis of TCD velocities in relation to age and hematocrit levels in adult SCD patients.

Main Results:

  • Adults with SCD exhibited higher mean time-averaged maximum mean velocities (110.9 cm/s) compared to healthy controls (71.1 cm/s).
  • The observed increase in TCD velocities in adults with SCD was proportional to the degree of anemia.
  • No adult patients in the study sample reached the >/=200 cm/s velocity threshold, which is used to indicate high stroke risk in children with SCD.

Conclusions:

  • Transcranial Doppler (TCD) velocities are generally lower in adults with sickle cell disease (SCD) compared to children with SCD.
  • The established velocity criteria for stroke risk stratification in pediatric SCD patients are not applicable to adult SCD patients.
  • Current TCD velocity thresholds used for children cannot reliably identify high stroke risk in adults with SCD.
Abstract

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