Samuel Ademola Adegoke1, Maria Stella Figueiredo2, Perla Vicari2, Henrique Carrete3, Marcos Hideki Idagawa3, Ayrton Roberto Massaro4, Gisele Sampaio Silva5. 1. Department of Pediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Hematology, UNIFESP, São Paulo, SP, Brazil. 2. Department of Hematology, UNIFESP, São Paulo, SP, Brazil. 3. Department of Radiology, UNIFESP, São Paulo, SP, Brazil. 4. Hospital Sírio-Libanês, São Paulo, SP, Brazil. 5. Department of Neurology and Neurosurgery, UNIFESP, São Paulo, SP, Brazil; Programa Integrado de Neurologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. Electronic address: giselesampaio@hotmail.com.
Abstract
BACKGROUND: The role of transcranial Doppler (TCD) ultrasonography in identifying children with sickle cell anemia (SCA) at risk for stroke is well known; however, the major studies that evaluated TCD velocities in children with SCA did not report posterior circulation evaluation data. The objective of our study was to describe the pattern of blood flow velocities in the posterior circulation of patients with SCA and to examine their relationship with findings on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA). METHODS: All adult patients with SCA followed in the outpatient clinic of our hospital were evaluated with TCD and MRI/MRA. The highest velocities of the middle cerebral arteries or internal carotid arteries were taken as the time-averaged maximum mean (TAMM) velocity for each patient and the maximum mean flow velocities in the posterior circulation (TAMMpost) were recorded. RESULTS: Fifty-six patients with SCA and 56 healthy nonanemic volunteers were evaluated. The mean TAMMpost in the basilar, vertebral, and posterior cerebral arteries (PCAs) were significantly higher among cases than controls (P < .01). In patients with SCA, the TAMMpost in all posterior circulation arteries had a positive correlation with TAMM. Only 1 patient with stenosis in the posterior circulation (right PCA) was identified. CONCLUSION: We found a low frequency of stenosis but high blood flow velocities in the posterior circulation in patients with SCA. The role of increased TCD velocities in the posterior circulation upon stroke risk in patients with SCA should be further examined.
BACKGROUND: The role of transcranial Doppler (TCD) ultrasonography in identifying children with sickle cell anemia (SCA) at risk for stroke is well known; however, the major studies that evaluated TCD velocities in children with SCA did not report posterior circulation evaluation data. The objective of our study was to describe the pattern of blood flow velocities in the posterior circulation of patients with SCA and to examine their relationship with findings on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA). METHODS: All adult patients with SCA followed in the outpatient clinic of our hospital were evaluated with TCD and MRI/MRA. The highest velocities of the middle cerebral arteries or internal carotid arteries were taken as the time-averaged maximum mean (TAMM) velocity for each patient and the maximum mean flow velocities in the posterior circulation (TAMMpost) were recorded. RESULTS: Fifty-six patients with SCA and 56 healthy nonanemic volunteers were evaluated. The mean TAMMpost in the basilar, vertebral, and posterior cerebral arteries (PCAs) were significantly higher among cases than controls (P < .01). In patients with SCA, the TAMMpost in all posterior circulation arteries had a positive correlation with TAMM. Only 1 patient with stenosis in the posterior circulation (right PCA) was identified. CONCLUSION: We found a low frequency of stenosis but high blood flow velocities in the posterior circulation in patients with SCA. The role of increased TCD velocities in the posterior circulation upon stroke risk in patients with SCA should be further examined.
Authors: Shuai Yuan; Lori C Jordan; Larry T Davis; Petrice M Cogswell; Chelsea A Lee; Niral J Patel; Spencer L Waddle; Meher Juttukonda; R Sky Jones; Allison Griffin; Manus J Donahue Journal: Br J Haematol Date: 2020-12-16 Impact factor: 6.998