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Updated: Jan 18, 2026
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Transcranial Doppler in 150 Congolese children with sickle cell disease
Gisele Tshiama Kazadi1, Didier Mukendi Mbuyi2, Robert Kitenge3
1Department of Pediatrics, Monkole Hospital, Kinshasa, Democratic Republic of Congo.
Insights
In Congolese children with Sickle Cell Disease (SCD), 14% had abnormal Transcranial Doppler (TCD) results, indicating a high stroke risk. Early TCD screening is crucial for preventing stroke complications in these young patients.
Area of Science:
- Neurology
- Hematology
- Pediatrics
Background:
- Sickle Cell Disease (SCD) is a prevalent global genetic disorder, with high incidence in sub-Saharan Africa.
- Stroke is a major cause of disability and mortality in SCD patients.
- Transcranial Doppler (TCD) is recommended for non-invasive stroke risk assessment in young SCD patients.
Purpose of the Study:
- To determine the prevalence of abnormal TCD findings in young Congolese SCD patients.
- To assess the association between pathological TCD results and hematological parameters.
Main Methods:
- A cross-sectional study of 150 Congolese children (ages 2-16) with SCD in stable condition.
- TCD was performed using the STOP I method to measure mean maximum velocity in the middle cerebral artery (MCA).
- Stroke risk was categorized based on MCA velocity: normal (<170 cm/s), conditional (170-199 cm/s), and pathological (≥200 cm/s).
Main Results:
- The prevalence of pathological TCD was 4%, and conditional TCD was 10%.
- A significant difference in WBC, Hb, Hct, and MCV was observed between normal and at-risk TCD groups.
- No significant association was found for categorical hematological parameters.
Conclusions:
- Globally, 14% of the studied children were at risk of stroke.
- Integrating TCD into routine SCD monitoring is essential for stroke prevention.
- Interventions like chronic blood transfusions or hydroxycarbamide may mitigate stroke risk.
Introduction:
Sickle Cell Disease (SCD) ranks among the most prevalent genetic disorders globally. The incidence in sub-Saharan African countries has been estimated to be 230.000/y with a high prevalence (1%) in the Democratic Republic of Congo (DRC). Stroke is a significant complication of Sickle Cell Disease (SCD), and carries a high risk of disability and mortality. Transcranial Doppler (TCD) is currently the non-invasive exploration recommended for the prevention of stroke in young SCD patients.
Objective:
To determine the prevalence of pathological TCD in a population of young Congolese SCA patients and to assess its association with hematological parameters.
Population And Methods:
This cross sectional study was carried out on 150 Congolese SS homozygous children between the ages 2-16 years old (mean age: 8.5 ± 4.0 years) in stable condition, and followed from January 1 to December 31, 2013. TCD was performed using the STOP I method in the main cerebral arteries. The risk of stroke was absent when the average maximum speed during a cycle (TAMMV) in middle cerebral artery (MCA) was < 170 cm/s, but present when TAMMV was borderline or conditional for values between 170 and 199 cm/s and pathological for values ≥ 200 cm/s.
Results:
The prevalence of pathological TCD was 4% while the conditional TCD prevalence was 10%. The Mean blood velocity in MCA was 114.0 cm/s. There was a significant difference in the means of WBC (p = 0.003), Hb (p < 0.001), Hct (p < 0.001), MCV (p = 0.005) parameters when comparing normal and at risk TCD (conditional and abnormal). However, no significant association was found for the categorical corresponding parameters.
Conclusion:
Globally, 14% of patients were at risk of stroke, hence the interest in integrating TCD in the routine monitoring of children with SCD in order to prevent overt stroke by implementing a chronic blood transfusion program or the use of hydroxycarbamide.
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Published on: June 3, 2021
