Related Experiment Video

Updated: May 6, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

14.7K

Incident Stroke in Pediatric Sickle Cell Anemia Despite Overall Improved Transcranial Doppler Velocity in a Ugandan

Bill Wambaka1, Amiirah Mpungu1, Vincent Mboizi1

  • 1Global Health Uganda, Kampala, Uganda.

Pediatric Blood & Cancer
|April 22, 2025
PubMed

Insights

Transcranial Doppler ultrasound (TCD) screening for stroke risk in children with sickle cell anemia (SCA) may be less effective in Uganda. Additional factors like anemia and low fetal hemoglobin (HbF) also contribute to stroke risk.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Global Health

Background:

  • Stroke is a major complication of sickle cell anemia (SCA) in children.
  • Transcranial Doppler (TCD) ultrasound is used for primary stroke prevention in high-resource settings.
  • Identifying stroke risk factors in low-resource regions like Uganda is crucial.

Purpose of the Study:

  • To evaluate stroke risk factors in Ugandan children with SCA.
  • To assess the effectiveness of TCD screening in this population.
  • To investigate the role of hydroxyurea (HU) therapy in brain protection.

Main Methods:

  • A 30-month open-label, single-arm trial of dose-escalated hydroxyurea in Ugandan children (3-9 years) with SCA.
  • Included clinical assessments, TCD, and laboratory tests.
  • Prospective monitoring for stroke events.

Main Results:

  • 15.7% of 264 children had abnormal TCD at enrollment.
  • Four children without abnormal TCD developed stroke within 16 months.
  • Stroke risk factors included low fetal hemoglobin (HbF ≤3.1%), hypoxemia, and severe anemia.

Conclusions:

  • TCD screening alone may not fully identify high stroke risk in Uganda.
  • Anemia, low HbF, hypoxemia, and infections are significant stroke contributors.
  • Primary stroke prevention from early childhood and continuous hydroxyurea therapy are recommended.
Abstract

Keywords:
Clinical trialhydroxyureasickle cell anemiasickle cell diseasestroke

More Related Videos

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload05:23

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

19.2K
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy07:24

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy

1.7K

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
582
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
53
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
68
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
34
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
52