Transcranial Doppler correlation with cerebral angiography in sickle cell disease.
OBJECTIVE
Cerebral infarction in sickle cell disease is associated with arterial narrowing or occlusions of intracranial arteries. Primary stroke prevention would be feasible if a noninvasive screening test could be developed to detect intracranial disease in patients before symptoms develop.


METHODS
To determine the sensitivity and specificity of transcranial Doppler in detecting significant (greater than or equal to 50% lumen diameter reduction) intracranial arterial lesions, we compared transcranial Doppler and cerebral angiography in a primarily young, symptomatic group of 33 patients (18 males and 15 females) with sickle cell disease.


RESULTS
From a total of 34 examinations, transcranial Doppler detected significant abnormalities in 26 of 29 (sensitivity 90%, specificity 100%). Five were normal by both techniques. The transorbital examination detected abnormalities in two patients whose studies were otherwise unremarkable.


CONCLUSIONS
Transcranial Doppler is sensitive and specific for the detection of arterial vasculopathy of sickle cell disease. Screening should include a transorbital examination of the distal internal carotid artery as well as examination using the transtemporal approach.
Adams
R J
RJ
Department of Neurology, Medical College of Georgia, Augusta 30912.
Nichols
F T
FT
Figueroa
R
R
McKie
V
V
Lott
T
T
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000000981:diagnostic imaging*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D014463:Ultrasonography