title: Recurrent large volume silent strokes in sickle cell disease.
abstract: Cerebrovascular events are very common in sickle cell disease (SCD), and multiple mechanisms are probably involved in their pathophysiology. We report a 30-year-old woman who presented a large volume silent stroke followed 2 months later by a second large volume stroke that manifested only with transient arm weakness. In the acute phase, magnetic resonance angiography revealed a segmental stenosis of the 2 different large intracranial vessels supplying the stroke territories. Partial regression of vascular stenosis was revealed by a follow-up magnetic resonance imaging. Present case suggests that stenosis of large intracranial vessels, possibly related to vascular injury promoted by the endothelial adhesion of reticulocytes and inflammatory elements, is involved in large volume brain infarcts in SCD.
authors.affiliation: Institute of Neurology, Università Campus Bio-Medico, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Marano
authors.affiliation: Institute of Radiology, Università Campus Bio-Medico, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Quattrocchi
authors.affiliation: Institute of Hematology, Università Campus Bio-Medico, Rome, Italy.
authors.forename: Ombretta
authors.initials: O
authors.lastname: Annibali
authors.affiliation: Institute of Hematology, Università Campus Bio-Medico, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Avvisati
authors.affiliation: Institute of Neurology, Università Campus Bio-Medico, Rome, Italy; Fondazione Alberto Sordi - Research Institute for Ageing, Rome, Italy. Electronic address: v.dilazzaro@unicampus.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Lazzaro
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D058070:Asymptomatic Diseases; D001803:Blood Transfusion; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
keywords: Sickle cell disease; intracranial artery stenosis; silent cerebral infarct; stroke