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Subarachnoid hemorrhage in sickle cell disease
J Carey1, Y Numaguchi, J Nadell
1Department of Radiology, Tulane University Medical School, New Orleans, LA 70112.
Summary
Subarachnoid hemorrhage is a rare neurological complication in sickle cell disease patients. This case highlights a potential cause: the rupture of leptomeningeal collateral vessels.
Area of Science:
- Neurology
- Hematology
- Pediatrics
Background:
- Sickle cell disease (SCD) is a genetic blood disorder associated with various neurological complications.
- Subarachnoid hemorrhage (SAH) is an uncommon but serious neurological event in SCD patients, occurring in 1%-2% of those with complications.
Observation:
- A 13-year-old female with SCD presented with symptoms indicative of SAH.
- Brain imaging revealed diffuse SAH in the right sylvian fissure and right frontoparietal regions.
- Cerebral angiography excluded aneurysms but showed bilateral stenosis/occlusion in distal anterior and middle cerebral artery branches.
Findings:
- The patient's SAH was associated with significant cerebrovascular abnormalities, including multiple arterial stenoses or occlusions.
- No aneurysm was identified as the source of bleeding.
Implications:
- This case suggests that rupture of leptomeningeal collateral vessels may be a potential mechanism for SAH in pediatric SCD patients.
- Understanding these vascular complications is crucial for managing neurological issues in SCD.
- Further research into the pathogenesis of SAH in SCD is warranted.