Sickle cell anemia: Intracranial stenosis and silent cerebral infarcts in children with low risk of stroke

Abstract Purpose: Children with sickle cell anemia (SCA), who have mean blood flow velocities Patients/methods We studied prospectively a cohort of 67 children with SCA without prior clinically overt stroke or TIA (median age 8.8 years; range limits 2.3–13.1 years; 33 females) and with TCD mean velocity Results In 7 children (10.5%, 95% CI: 4.9–20.3%) we found 10 stenoses, including 4 with isolated left tICA stenosis and 3 with multiple stenoses. We found silent infarcts in 26 children (37.7%, 95% CI: 27.2–49.5%). The median number of infarcts in an affected child was 2 (range limits: 1–9), median volume of infarcts was 171 mm 3 (range limits: 7–1060 mm 3 ), and median infarct volume in relation to total brain volume was 0.020% (range limits: 0.001–0.101%). The number and volume of infarcts were significantly higher in children with arterial stenosis (both p  = 0.023). Conclusions The prevalence of intracranial arterial stenosis in children with SCA classified as at low risk of stroke by TCD mean velocity