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Laboratory and clinical correlates for magnetic resonance imaging (MRI) abnormalities in pediatric sickle cell anemia

Jeffrey D Lebensburger1, Lee M Hilliard, Tony M McGrath

  • 1Division of Pediatric Hematology Oncology, University of Alabama-Birmingham, Alabama, USA. jlebensburger@peds.uab.edu

Journal of Child Neurology
|May 17, 2011
PubMed

Insights

Brain MRI screening for sickle cell anemia in children is recommended for those with seizure, sensory, or motor events. High blood pressure, high white blood cell count, and severe anemia also indicate higher brain injury risk.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Children with sickle cell anemia face a significant risk of developing brain injuries.
  • Brain magnetic resonance imaging (MRI) is a key diagnostic tool for identifying these injuries.
  • Current guidelines debate the necessity of routine MRI screening for all children with sickle cell anemia.

Purpose of the Study:

  • To investigate the clinical and laboratory factors associated with brain injury in children with sickle cell anemia.
  • To determine if specific neurological symptoms or findings predict the presence of brain injury.

Main Methods:

  • Retrospective analysis of 124 brain MRI scans obtained for various clinical indications in children with sickle cell anemia.
  • Evaluation of correlations between clinical presentations, laboratory results, vital signs, and MRI-diagnosed brain injuries.

Main Results:

  • Seizures, sensory events, or motor deficits were strongly associated with a higher likelihood of brain injury.
  • Less specific symptoms like headaches or poor school performance did not show a significant association with brain injury.
  • Elevated systolic blood pressure, leukocytosis (high white blood cell count), and severe anemia were linked to an increased probability of brain injury.

Conclusions:

  • Brain MRI is indicated for children with sickle cell anemia presenting with seizure, sensory, or motor events.
  • Screening for brain injury should be considered in children with less specific neurological symptoms if accompanied by abnormal physical findings, laboratory results, or vital signs.

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