Related Experiment Video

Updated: Jul 19, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
05:23

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Treatment and prevention of stroke in children with sickle cell disease

Shyamal H Mehta1, Robert J Adams

  • 1Department of Neurology, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA. rjadams@mcg.edu.

Current Treatment Options in Neurology
|October 13, 2006
PubMed

Insights

Regular blood transfusions significantly reduce stroke risk in children with sickle cell disease (SCD). Transcranial Doppler (TCD) screening identifies high-risk children, making transfusions a proven stroke prevention strategy.

Area of Science:

  • Neurology
  • Hematology
  • Pediatrics

Background:

  • Stroke is a significant complication in children with sickle cell disease (SCD), ranging from silent infarcts to severe, disabling lesions.
  • Intracranial hemorrhages in SCD can result from aneurysms, moyamoya disease, or venous issues.
  • While acute stroke treatments are limited, evidence supports stroke prevention strategies in this population.

Purpose of the Study:

  • To review the evidence for stroke prevention in children with sickle cell disease.
  • To highlight the effectiveness of transcranial Doppler (TCD) screening and blood transfusions in primary stroke prevention.
  • To discuss current and potential secondary stroke prevention methods.

Main Methods:

  • The Stroke Prevention Trial in Sickle Cell Anemia (STOP) randomized high-risk children (TCD velocity ≥ 200 cm/s) to transfusion or no transfusion.
  • STOP2 evaluated the impact of discontinuing transfusions on stroke risk.
  • Review of existing literature on stroke prevention in SCD.

Main Results:

  • The STOP trial demonstrated a 90% reduction in first-time stroke among children receiving regular blood transfusions.
  • Discontinuing transfusions in STOP2 led to a high rate of abnormal TCD values and recurrent strokes.
  • TCD screening and chronic transfusion (maintaining HbS < 30%) is the only established primary stroke prevention strategy for SCD.

Conclusions:

  • Transcranial Doppler (TCD) screening and maintaining low hemoglobin S levels through chronic transfusion is the sole proven method for primary stroke prevention in children with SCD.
  • Further research is needed for secondary stroke prevention, with hydroxyurea under investigation.
  • Bone marrow transplantation shows potential for stroke prevention but requires more data.

More Related Videos

Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry08:23

Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry

Published on: November 5, 2019

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic 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...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic 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...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic 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...
Ischemic Stroke l: Introduction01:15

Ischemic 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.
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...