Cranial involvement in sickle cell disease.
OBJECTIVE
To evaluate cranial findings in patients with neurologically symptomatic sickle cell disease (SCD).


METHODS
We studied 50 consecutive patients with SCD and neurologic symptoms. All patients underwent brain MR examinations: all 50 underwent classic MR imaging; 42, diffusion-weighted MR imaging; 10, MR angiography; four, MR venography; and three patients, digital subtraction angiography.


RESULTS
Of the 50 SCD patients, 19 (38%) had normal MR findings, and 31 (62%) showed abnormalities on brain MR images. Of the 50 patients, 16 (32%) had ischemic lesions; two (4%), subarachnoid hemorrhage; one (2%), moya-moya pattern; one (2%), posterior reversible encephalopathy; one (2%), dural venous sinus thrombosis; 12 (24%), low marrow signal intensity and thickness of the diploic space; 12 (24%), cerebral atrophy; and two (4%), osteomyelitis. Twenty-seven patients (54%) presented with headache, which was the most common clinical finding.


CONCLUSIONS
The cranial involvement is one of the most devastating complications of SCD. Early and accurate diagnosis is important in the management of cranial complications of SCD.
Alkan
Ozlem
O
Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey. yalinozlem@hotmail.com
Kizilkilic
Ebru
E
Kizilkilic
Osman
O
Yildirim
Tulin
T
Karaca
Sibel
S
Yeral
Mahmut
M
Kasar
Mutlu
M
Ozdogu
Hakan
H
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis*; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult