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Assessment of Cerebral Lateralization in Children using Functional Transcranial Doppler Ultrasound fTCD
Published on: September 27, 2010
Stroke risk assessment in children with sickle cell disease using transcranial Doppler ultrasound in Cameroon
Sylviane Dongmo Fomekong1,2, Yanelle Wandji1, Marlyse Epotto1
1Department of Internal Medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Insights
About 8.2% of children with sickle cell disease have high cerebral artery velocities, indicating elevated stroke risk. Vaccinations may be protective, while infections increase risk, highlighting the need for Transcranial Doppler Ultrasound screening.
Area of Science:
- Neurology
- Pediatrics
- Hematology
Background:
- Stroke is a major complication of sickle cell disease (SCD) due to cerebral vasculopathy.
- Transcranial Doppler (TCD) Ultrasound is a proven method for predicting stroke risk in SCD patients.
- Early detection allows for timely preventive interventions.
Purpose of the Study:
- To assess cerebral vasculopathy in children with SCD using TCD.
- To identify stroke risk factors in pediatric SCD patients in Cameroon.
Main Methods:
- A cross-sectional study involving 110 children (aged 2-16) with SCD was conducted in three Cameroonian hospitals.
- Cerebral blood flow velocities were measured using TCD.
- Data on clinical factors and stroke risk were analyzed using statistical methods.
Main Results:
- 79.1% of children had normal arterial velocities, 12.7% had intermediate, and 8.2% had high velocities, indicating elevated stroke risk.
- Acute chest infections were associated with high velocities.
- Prophylactic vaccinations (meningococcal, pneumococcal) showed a protective association.
Conclusions:
- 8.2% of children with SCD exhibited high cerebral artery velocities, signifying a high stroke risk.
- Acute chest infections may increase stroke risk, while vaccinations appear protective.
- TCD is a valuable tool for early stroke risk stratification in pediatric SCD populations, especially in resource-limited settings.
Introduction:
Stroke is a severe complication of sickle cell disease, often resulting from cerebral vasculopathy. Transcranial Doppler Ultrasound is a validated tool for stroke risk prediction in sickle cell disease, enabling timely preventive interventions. This study assessed cerebral vasculopathy in children with sickle cell disease using transcranial Doppler in three hospitals in Cameroon.
Methods:
a cross-sectional study was conducted from January to April 2024 in Buea, Limbe, and Laquintinie Hospitals. Children aged 2-16 years with confirmed sickle cell disease were evaluated. Data on demographics, clinical history, immunization status, hematological parameters, and cerebral blood flow velocities (time-averaged mean maximum velocity and peak systolic velocity in the middle cerebral and distal internal carotid arteries) were collected. Stroke risk was classified per the stroke prevention trial for sickle cell anemia (STOP) trial criteria. Statistical analysis included descriptive, bivariate, and multivariate methods (SPSS v23.0), with significance set at p<0.05.
Results:
among 110 participants (mean age 8.35 ± 3.74 years), 79.1% had normal arterial velocities, 12.7% intermediate, and 8.2% high velocities, indicating elevated stroke risk. Acute chest infections could be significantly associated with high velocities, while prophylactic vaccination (meningococcal and pneumococcal) could be protective.
Conclusion:
approximately 8.2% of children with sickle cell disease showed high cerebral artery velocities, suggesting high stroke risk. Acute chest infections may exacerbate this risk, whereas vaccination could appear protective. Transcranial Doppler is a valuable tool for early stroke risk stratification in pediatric sickle cell disease populations in resource-limited settings.
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