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Primary and Secondary Stroke Prevention in Children With Sickle Cell Disease

A Kyle Mack, Alexis A Thompson

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |July 18, 2016
    PubMed

    Insights

    Children with sickle cell disease (SCD) face serious central nervous system (CNS) complications. Early detection of silent cerebral infarcts and stroke through transcranial Doppler ultrasonography is crucial for management and prevention.

    Area of Science:

    • Pediatric Neurology
    • Hematology
    • Medical Imaging

    Background:

    • Sickle cell disease (SCD) presents significant challenges for children, including debilitating central nervous system (CNS) complications.
    • Early identification of CNS disease risk factors and overt CNS disease is critical for primary care providers.

    Purpose of the Study:

    • To discuss silent cerebral infarcts as an early indicator of CNS disease in children with SCD.
    • To review overt stroke in pediatric SCD patients.
    • To provide guidance on transcranial Doppler ultrasonography (TCD) for CNS disease in SCD.

    Main Methods:

    • Review of clinical data regarding silent cerebral infarcts and overt stroke in pediatric SCD.
    • Discussion of transcranial Doppler ultrasonography (TCD) protocols, including screening frequency and management of abnormal findings.

    Main Results:

    • Silent cerebral infarcts represent an emerging early indicator of CNS disease in children with SCD.
    • Overt stroke is a recognized severe complication in pediatric SCD.
    • TCD is a key tool for screening and monitoring CNS involvement.

    Conclusions:

    • Timely recognition and management of CNS disease indicators like silent cerebral infarcts are vital for preventing debilitating outcomes in children with SCD.
    • Established protocols for TCD screening and management of abnormal results are essential for optimizing care.
    • Comprehensive strategies are needed for the prevention and management of both silent cerebral infarcts and overt stroke in pediatric SCD patients.

    Keywords:
    Cerebral infarctsickle cell diseasestroketranscranial Doppler ultrasonography

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