Outcome of overt stroke in sickle cell anaemia, a single institution's experience

Area of Science:

• Hematology
• Neurology
• Pediatrics

Background:

• Stroke is a serious complication in sickle cell anemia (SCA), leading to significant morbidity and high recurrence rates.
• Recurrent overt stroke in pediatric SCA patients poses a substantial risk, estimated at 2.2-6.4 events per 100 patient-years.

Purpose of the Study:

• To evaluate the outcomes and recurrence rates of overt stroke in pediatric patients with SCA.
• To assess the effectiveness of treatments, including red blood cell transfusions and aspirin, in preventing recurrent strokes.

Main Methods:

• Retrospective study of pediatric SCA patients diagnosed with overt stroke between 1997 and 2010.
• Analysis of patient demographics, treatment regimens (red blood cell transfusions, aspirin), and stroke recurrence over a 305 patient-year observation period.

Main Results:

• Out of 31 pediatric SCA patients with new-onset overt stroke, 27 were actively followed for 305 patient-years.
• 81% received long-term red blood cell transfusions, and 59% took aspirin post-stroke.
• A low recurrence rate of 0.66/100 patient-years was observed, with only 7% experiencing a second stroke (one ischemic, one hemorrhagic).

Conclusions:

• Pediatric SCA patients demonstrate excellent outcomes following overt stroke with a low risk of recurrence.
• Aspirin therapy may contribute to preventing recurrent strokes, particularly hemorrhagic ones, but its risk-benefit profile requires further investigation.