Pathophysiology and treatment of stroke in sickle-cell disease

present and future

Research output: Contribution to journalReview article

144 Citations (Scopus)

Abstract

Sickle-cell anaemia is the most common cause of stroke in children, and stroke is one of the most devastating complications of sickle-cell disease. Overt strokes are typically due to large-artery vasculopathy affecting the intracranial internal carotid arteries and proximal middle cerebral arteries, whereas silent strokes typically occur in the territory of penetrating arteries. The sickled red blood cell can contribute to the pathogenesis of stroke via abnormal adherence to the vascular endothelium and by haemolysis, which results in endothelial cell activation, a hypercoaguable state, and alterations in vasomotor tone. Red-blood-cell transfusion, the most common preventive measure for stroke in sickle-cell disease, is associated with iron overload in chronic disease. Therefore, interventions directed towards the potential mechanisms that promote vasculopathy and occlusion in sickle-cell anaemia should be investigated. Here we review the epidemiology, clinical spectrum, and pathophysiology of stroke in sickle-cell disease to identify potential therapeutic targets.

Original languageEnglish (US)
Pages (from-to)501-512
Number of pages12
JournalLancet Neurology
Volume5
Issue number6
DOIs
StatePublished - Jun 1 2006

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Sickle Cell Anemia
Stroke
Therapeutics
Arteries
Erythrocyte Transfusion
Iron Overload
Vascular Endothelium
Middle Cerebral Artery
Internal Carotid Artery
Hemolysis
Epidemiology
Chronic Disease
Endothelial Cells
Erythrocytes

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Pathophysiology and treatment of stroke in sickle-cell disease : present and future. / Switzer, Jeffrey A; Hess, David C; Nichols, Fenwick T; Adams, Robert J.

In: Lancet Neurology, Vol. 5, No. 6, 01.06.2006, p. 501-512.

Research output: Contribution to journalReview article

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