LONG-TERM STROKE RISK IN CHILDREN WITH SICKLE-CELL DISEASE SCREENED WITH TRANSCRANIAL DOPPLER

Stroke is an important complication of sickle cell disease. Stroke pre diction is clinically important because it offers the possibility of p rimary prevention. In 1992, transcranial Doppler (TCD) evidence of ele vated intracranial internal carotid or middle cerebral artery velocity was demonstrated to be associated strongly with an increased risk of ischemic stroke. This study extends the original study and includes 12 5 more children, longer follow-up, and intracranial hemorrhage in the stroke-risk model. Elevated time averaged mean maximum blood now veloc ity, especially when velocity is 200 cm/sec or greater by TCD, was ass ociated strongly with stroke risk. The cases not predicted by TCD poin t to the need for more information on the optimal timing of TCD survei llance for stroke risk.