Stroke prevention in the young child with sickle cell anaemia.
Cerebrovascular disease resulting in stroke is a serious and preventable complication of sickle cell anaemia (SCA). Children at high risk of preventable stroke can be identified by transcranial Doppler ultrasound (TCD). Current guidelines in the UK recommend annual TCD screening from 3 years, although studies suggest an earlier peak incidence, between 2 and 5 years. A single centre retrospective review was undertaken to identify the prevalence of stroke and success of TCD screening in young children. We report five episodes of stroke in under 3s and outcome of TCD screening in children under 3, compared to over 3. TCD analysis was as successful in the 2-3-year age group as in the 3-4-year group. We therefore propose that all children with SCA should be offered TCD screening from the age of 2 years. Furthermore, infants with high risk features of SCA should undergo a first attempt at TCD screening even earlier.
Roberts
Lara
L
Department of Paediatric Haematology, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK.
O'Driscoll
Sandra
S
Dick
Moira C
MC
Height
Sue E
SE
Deane
Colin
C
Goss
David E
DE
Pohl
Keith
K
Rees
David C
DC
D000755:Anemia, Sickle Cell / Q000150:complications*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D015995:Prevalence; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D017585:Ultrasonography, Doppler, Transcranial