Main Article Content
Transcranial Doppler Ultrasonography, Cerebrovascular Accident
Cerebrovascular accident (CVA) is a common devastating neurological complication of sickle cell disorder (SCD) with a high recurrent and mortality rate. The Stroke Prevention Trial in Sickle Cell Anaemia study (STOP) recommends routine screening with transcranial Doppler ultrasonography in children aged two to sixteen years with SCD. The present study assessed cerebral blood flow velocities of children with SCD in accordance with the recommendation of routine screening by the STOP study.
Methods: Transcranial Doppler ultrasonography was done for children with SCD that attended Sickle Cell Foundation, Nigeria between July and November 2015.
Results: In all, 388 subjects were screened within the study period (360 HbSS and 28 HbSC). The prevalence of abnormal Time-Averaged Maximum Mean Velocity (TAMMV) of at least 200cm/second was 10.8%: this was seen solely in HbSS subjects. The mean Time-averaged mean of the maximum (TAMM) velocity were 163 ± 25cm/sec, 162±30cm/sec and 150 ± 30cm/sec for children less than five years, five to ten years and eleven to sixteen years respectively.
Conclusion: The prevalence of abnormal TAMM velocity is high in children with HbSS. The need for availability of and accessibility to transcranial Doppler screening is emphasized.
1. Diallo D, Tchernia G. Sickle Cell Disease in Africa. Curr Opin Haematol 2002;9:111
2. Akinyanju OO. A profile of sickle cell disease in Nigeria. Ann N Y Acad Sci. 1989;565:126–36.
3. Ohene-Frempong K, Weiner S, Sleeper L, Miller S, Embury S, Moohr J. Cerebrovascular accidents in Sickle Cell Disease: Rates and Risk Factors. Blood. 1998;91(1):288–94.
4. Hsu L. Specific Problems: Neurologic symptoms and strokes. Available at: scinfo.org/problem-oriented-clinical-guidelines/specific-problems-neurologic-symptoms-and-stroke. Accessed December 9,2013.
5. George I, Frank-Briggs A. Stroke in Nigerian Children with Sickle Cell Anaemia. J Public Health Epidemiol. 2011;3(9):407–9.
6. Fatunde OJ, Adamson FG, Ogunseyinde O, Sodeinde O, Familusi JB. Stroke in Nigerian children with sickle cell disease. Afr J Med Med Sci 2005 ;34(2):157–60.
7. Lagunju IA, Brown BJ, Famosaya AA. Childhood stroke in sickle cell disease in Nigeria. J Pediatr Neurol. 2011;9(1):49–53
8. Adams RJ, Nichols FT, Figueroa R, McKie V, Lott T. Transcranial Doppler correlation with cerebral angiography in sickle cell disease. Stroke. 1992;23(8):1073–7
9. Nichols F, Jones A, Adams R. Stroke Prevention in Sickle Cell Disease(STOP) Study Guidelines for Transcranial Doppler Testing. J neeuroimaging. 2001;11(4):354–62
10. Lagunju I, Sodeinde O, Brown B, Akinbami F, Adedokun B. Transcranial doppler ultrasonography in children with sickle cell anemia: Clinical and laboratory correlates for elevated blood flow velocities. J Clin Ultrasound. 2014;42(2):89–95
11. Lagunju I, Sodeinde O, Telfer P. Prevalence of transcranial Doppler abnormalities in Nigerian children with sickle cell disease. Am J Hematol 2012;87(5):544–7.
12. Oniyangi O, Akano AO, Wakama TT, Oyesakin AB. Transcranial Doppler ultrasound studies for the primary prevention of strokes among children with sickle cell disease in Nigeria- a single tertiary center experience. Research 2014;1:825.
13. Kwiatkowski JL, Hunter JV, Smith-Whitley K, Katz ML, Shults J. Transcranial doppler ultrasonography in siblings with sickle cell disease. Br J Haematol. 2003;121:375–80
14. Adams RJ, McKie VC, Brambilla D, Carl E, Gallagher D, Nichols FT, Roach S, Abboud M, Berman B, Driscoll C, Files B, Hsu L, Hurlet A, Miller S, Olivieri N, Pegelow C, SCher C, Vichinsky E, Wang W, Woods G, Kutler A, Wright E, Hagner S, Tighe F, Waclawiw MA, et al. Stroke prevention trial in sickle cell anemia. Control Clin Trials 1998;19(1):110–29
15. Adams RJ, Ohene-Frempong K, Wang W. Sickle cell and the brain. American Society of Haematology. 2001;31–46
16. Deane CR, Goss D, O’Driscoll S, Mellor S, Pohl KR, Dick MC, et al. Transcranial Doppler scanning and the assessment of stroke risk in children with haemoglobin sickle cell disease. Arch Dis Child. 2008;93(2):138.