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Stroke in sickle cell anemia: alternative etiologies

Michael M Dowling1, Charles T Quinn, Zora R Rogers

  • 1Department of Pediatrics, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9063, USA. Michael.dowling@utsouthwestern.edu

Pediatric Neurology
|July 11, 2009
PubMed

Insights

Pediatric stroke in sickle cell anemia can stem from traditional causes, not just sickle cell disease itself. This case highlights cardioembolic stroke patterns in a child with sickle cell anemia, emphasizing broader diagnostic considerations.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Cardiology

Background:

  • Stroke is a frequent complication in pediatric sickle cell anemia.
  • Traditional stroke causes are often overlooked in these patients.

Observation:

  • An 11-year-old girl with sickle cell anemia presented with severe headache.
  • She was diagnosed with recurrent bilateral multifocal strokes exhibiting a cardioembolic pattern.

Findings:

  • Evaluation revealed a patent foramen ovale, antiphospholipid antibodies, and elevated factor VIII and lipoprotein(a).
  • Sickle cell anemia creates a hypercoagulable state and can increase right heart pressures, predisposing to paradoxical embolization.

Implications:

  • This case suggests that traditional stroke etiologies should be investigated in children with sickle cell anemia.
  • Recognizing these co-existing factors is crucial for accurate diagnosis and management of pediatric stroke in sickle cell disease.

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