Transcranial Doppler scanning and the assessment of stroke risk in children with HbSC [corrected] disease.
OBJECTIVE
To assess the role of transcranial Doppler (TCD) scanning in assessing the risk of stroke in children with haemoglobin SC (HbSC) disease. TCD scanning has an established role in primary stroke prevention in sickle cell anaemia but its value in HbSC is unknown.


METHODS
A retrospective audit of routinely performed TCD scans and routinely collected clinical data.


METHODS
A paediatric sickle cell clinic in a teaching hospital in south London, UK.


METHODS
46 children with HbSC disease who have undergone routinely performed TCD scans and steady-state blood tests.


METHODS
The time-averaged mean of the maximum velocity (TAMMV) in the middle cerebral artery circulation correlated with clinical and laboratory data.


RESULTS
The mean TAMMV was 94 cm/s, with a 98(th) centile of 128 cm/s. This is significantly less than the published ranges for HbSS, with a mean reading of 129 cm/s. One child had a stroke at the age of 5 years, when her TAMMV was measured at 146 cm/s.


CONCLUSIONS
Further studies are needed to assess stroke risk in HbSC disease, but we suggest that TCD measurements are potentially useful in this condition, and that readings greater than 128 cm/s are abnormally high and warrant further investigation.
Deane
Colin R
CR
Department of Paediatric Haematology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Goss
David
D
O'Driscoll
Sandra
S
Mellor
Sarah
S
Pohl
Keith R E
KR
Dick
Moira C
MC
Height
Sue E
SE
Rees
David C
DC
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D010976:Platelet Count; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods