Cerebral vessel stenosis in sickle cell disease

Criteria for detection by transcranial doppler

Robert J. Adams, Fenwick T Nichols, Rune Aaslid, Virgil C. McKie, Kathy McKie, Elizabeth Carl, Sharon Stephens, William O. Thompson, Paul Milner, Ramon E Figueroa Ortiz

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Ischemic stroke is a common and disabling complication of sickle cell disease (Hb SS). Most infarctions occur in the presence of intracranial stenotic lesions of the large vessels of the circle of Willis. Transcranial Doppler (TCD), by measuring flow velocity in these arterial segments, can detect focal stenosis on the basis of elevated flow velocity. We report the preliminary results of a prospective study to develop criteria for detection of stenotic lesions based on TCD and identification of patients with Hb SS at risk for stroke. Comparing the TCD findings from six patients with lesions demonstrated by angiography to those from 115 Hb SS children without stroke, we conclude: (a) middle cerebral (MCA), anterior cerebral (ACA), or interna] carotid (ICA) artery mean velocities > 190 cm/s strongly suggest focal stenosis; (b) MCA or ACA mean velocities of 150 to 190 cm/s suggest abnormality but at present cannot be considered diagnostic of stenosis; (c) mean velocities up to 150 cm/s are possibly due to the effects of low hematocrit and/or young age, and cannot as yet be distinguished from velocity elevations due to vessel stenosis.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalJournal of Pediatric Hematology/Oncology
Volume12
Issue number3
DOIs
StatePublished - Jan 1 1990

Fingerprint

Sickle Cell Anemia
Pathologic Constriction
Stroke
Circle of Willis
Hematocrit
Carotid Arteries
Infarction
Angiography
Prospective Studies

Keywords

  • Cerebral vessel
  • Doppler
  • Sickle cell disease
  • Stenosis
  • Stroke
  • Transcranial

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Cerebral vessel stenosis in sickle cell disease : Criteria for detection by transcranial doppler. / Adams, Robert J.; Nichols, Fenwick T; Aaslid, Rune; McKie, Virgil C.; McKie, Kathy; Carl, Elizabeth; Stephens, Sharon; Thompson, William O.; Milner, Paul; Figueroa Ortiz, Ramon E.

In: Journal of Pediatric Hematology/Oncology, Vol. 12, No. 3, 01.01.1990, p. 277-282.

Research output: Contribution to journalArticle

Adams, Robert J. ; Nichols, Fenwick T ; Aaslid, Rune ; McKie, Virgil C. ; McKie, Kathy ; Carl, Elizabeth ; Stephens, Sharon ; Thompson, William O. ; Milner, Paul ; Figueroa Ortiz, Ramon E. / Cerebral vessel stenosis in sickle cell disease : Criteria for detection by transcranial doppler. In: Journal of Pediatric Hematology/Oncology. 1990 ; Vol. 12, No. 3. pp. 277-282.
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