title: Transcranial Doppler ultrasonography in adults with sickle cell disease.
abstract: BACKGROUND
  Transcranial Doppler (TCD) is used to select children with sickle cell disease (SCD) for primary stroke prevention using regular blood transfusion. Whether it can also identify high stroke risk in adults with SCD is not known.
  
  
  METHODS
  The authors examined 112 adult patients from two convenience population samples with SCD and 53 healthy control subjects to compare velocities in adults to those reported in children with SCD and to evaluate the influence of age and hematocrit on TCD.
  
  
  RESULTS
  Adults with SCD had a higher mean time-averaged maximum mean velocity (110.9 +/- 25.7 cm/s) compared with healthy controls (71.1 +/- 12.0 cm/s), and the difference is approximately proportional to their anemia. No cases with velocities >/=200 cm/s (the threshold used in children for prophylactic treatment) were found in this sample.
  
  
  CONCLUSIONS
  Transcranial Doppler velocities in adults with sickle cell disease (SCD) are lower than those in children with SCD. Velocity criteria used in children cannot be used to stratify risk of stroke in adults.
authors.affiliation: Department of Neurology, Medical College of Georgia, 1429 Harper St., HF 1154, Augusta, GA 30912, USA.
authors.forename: N
authors.initials: N
authors.lastname: Valadi
authors.forename: G S
authors.initials: GS
authors.lastname: Silva
authors.forename: L S
authors.initials: LS
authors.lastname: Bowman
authors.forename: D
authors.initials: D
authors.lastname: Ramsingh
authors.forename: P
authors.initials: P
authors.lastname: Vicari
authors.forename: A C
authors.initials: AC
authors.lastname: Filho
authors.forename: A R
authors.initials: AR
authors.lastname: Massaro
authors.forename: A
authors.initials: A
authors.lastname: Kutlar
authors.forename: F T
authors.initials: FT
authors.lastname: Nichols
authors.forename: R J
authors.initials: RJ
authors.lastname: Adams
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017585:Ultrasonography, Doppler, Transcranial / Q000706:statistics & numerical data*