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Subarachnoid hemorrhage in sickle-cell disease
J A Anson1, M Koshy, L Ferguson
1Department of Neurosurgery University of Illinois Hospital, Chicago.
Journal of Neurosurgery
|October 1, 1991
Summary
Subarachnoid hemorrhage (SAH) is not rare in sickle-cell disease patients, often occurring younger with smaller aneurysms. Proper management, including exchange transfusions, allows safe surgical intervention for these patients.
Area of Science:
- Neurology
- Hematology
- Neurosurgery
Background:
- Sickle-cell disease (SCD) is associated with various neurological complications.
- Subarachnoid hemorrhage (SAH) is an infrequently reported complication of SCD.
Observation:
- A review of 325 SCD patients identified 11 cases of SAH.
- Aneurysms were present in 10 of these 11 patients, with three having multiple aneurysms.
- SAH in SCD patients tends to occur at a younger age and with smaller aneurysms compared to the general population.
Findings:
- SCD patients with SAH can undergo craniotomy without increased hematological or neurological complications.
- Exchange transfusions to reduce hemoglobin S to <30% are crucial for perioperative management.
- Angiography and craniotomy are feasible with appropriate management strategies.
Implications:
- SAH should be considered in the differential diagnosis of neurological events in SCD patients.
- Early diagnosis and perioperative management are key to improving outcomes for SCD patients with SAH.
- This study highlights the importance of multidisciplinary care in managing complex neurological conditions in SCD.