title: Outcome of overt stroke in sickle cell anaemia, a single institution's experience.
abstract: Stroke is a traumatic complication in sickle cell anaemia (SCA) that is associated with significant morbidity and a risk of recurrent overt stroke of 2·2-6·4 events per 100 patient-years. A retrospective study was performed on all paediatric SCA patients diagnosed with a history of overt stroke between 1997 and 2010. A total of 31 children with SCA had new onset overt stroke. The mean age of the active patients (n = 27) was 17·9 years (range 6·8-27·6 years) with a total period of observation of 305 patient-years. Twenty-two of 27 (81%) were receiving long term red blood cell transfusions and 16 (59%) were taking the anti-platelet agent, aspirin, since diagnosis of the stroke. Two of 27 (7%) patients had a second overt stroke with an overall risk of recurrent stroke of 0·66/100 patient-years (one stroke was ischaemic and the other haemorrhagic). In patients taking aspirin with 180 patient-years of follow up, the recurrence rate of haemorrhagic stroke was 0·58/100 patient-years. We have an excellent outcome for overt stroke in paediatric SCA patients with a low rate of recurrent stroke. Further studies are needed to determine the risk-benefit ratio of aspirin therapy in the prevention of recurrent stroke in paediatric SCA.
authors.affiliation: Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Suvankar
authors.initials: S
authors.lastname: Majumdar
authors.forename: Morgan
authors.initials: M
authors.lastname: Miller
authors.forename: Majid
authors.initials: M
authors.lastname: Khan
authors.forename: Catherine
authors.initials: C
authors.lastname: Gordon
authors.forename: Amy
authors.initials: A
authors.lastname: Forsythe
authors.forename: Mary G
authors.initials: MG
authors.lastname: Smith
authors.forename: Gail
authors.initials: G
authors.lastname: Megason
authors.forename: Rathi
authors.initials: R
authors.lastname: Iyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D055502:Secondary Prevention; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: aspirin; platelet; sickle cell anaemia; stroke; survival