Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease

Charles H. Pegelow, Eric A. Macklin, Franklin G. Moser, Winfred C. Wang, Jacqueline A. Bello, Scott T. Miller, Elliott P. Vichinsky, Michael R. DeBaun, Ludovico Guarini, Robert A. Zimmerman, Donald P. Younkin, Dianne M. Gallagher, Thomas R. Kinney

Research output: Contribution to journalArticle

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Abstract

Children with sickle cell anemia (HbSS) are at high risk for neurologically overt cerebral infarcts associated with stroke and neurologically silent cerebral infarcts correlated with neuropsychometric deficit. We used complete magnetic resonance imaging (MRI) histories from 266 HbSS children, aged 6 through 19 years, who were enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) to examine silent infarct prevalence, localization, recurrence, and progression. We report a baseline prevalence of 21.8%, marginally higher than previously reported due to improved imaging technologies. Although we observed no overall sex difference in prevalence, most lesions in girls occurred before age 6, whereas boys remained at risk until age 10. Silent infarcts were significantly smaller and less likely to be found in the frontal or parietal cortex than were infarcts associated with stroke. Children with silent infarct had an increased incidence of new stroke (1.03/100 patientyears) and new or more extensive silent infarct (7.06/100 patient-years) relative to stroke incidence among all children in our cohort (0.54/100 patient-years). Both events were substantially less frequent than the risk of stroke recurrence among children not provided chronic transfusion therapy. Although chronic transfusion is known to decrease occurrence of new silent infarcts and strokes in children with elevated cerebral arterial blood flow velocity, further study is required to determine its risk-benefit ratio in children with silent infarct and normal velocities. Until safe and effective preventive strategies against infarct recurrence are discovered, MRI studies are best reserved for children with neurologic symptoms, neuropsychometric deficits, or elevated cerebral artery velocities.

Original languageEnglish (US)
Pages (from-to)3014-3018
Number of pages5
JournalBlood
Volume99
Issue number8
DOIs
StatePublished - Apr 15 2002
Externally publishedYes

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Sickle Cell Anemia
Magnetic resonance
Brain
Magnetic Resonance Imaging
Imaging techniques
Stroke
Recurrence
Flow velocity
Cerebrovascular Circulation
Blood
Parietal Lobe
Cerebral Arteries
Blood Flow Velocity
Incidence
Frontal Lobe
Neurologic Manifestations
Sex Characteristics
Odds Ratio
Technology

ASJC Scopus subject areas

  • Hematology

Cite this

Pegelow, C. H., Macklin, E. A., Moser, F. G., Wang, W. C., Bello, J. A., Miller, S. T., ... Kinney, T. R. (2002). Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease. Blood, 99(8), 3014-3018. https://doi.org/10.1182/blood.V99.8.3014

Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease. / Pegelow, Charles H.; Macklin, Eric A.; Moser, Franklin G.; Wang, Winfred C.; Bello, Jacqueline A.; Miller, Scott T.; Vichinsky, Elliott P.; DeBaun, Michael R.; Guarini, Ludovico; Zimmerman, Robert A.; Younkin, Donald P.; Gallagher, Dianne M.; Kinney, Thomas R.

In: Blood, Vol. 99, No. 8, 15.04.2002, p. 3014-3018.

Research output: Contribution to journalArticle

Pegelow, CH, Macklin, EA, Moser, FG, Wang, WC, Bello, JA, Miller, ST, Vichinsky, EP, DeBaun, MR, Guarini, L, Zimmerman, RA, Younkin, DP, Gallagher, DM & Kinney, TR 2002, 'Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease', Blood, vol. 99, no. 8, pp. 3014-3018. https://doi.org/10.1182/blood.V99.8.3014
Pegelow, Charles H. ; Macklin, Eric A. ; Moser, Franklin G. ; Wang, Winfred C. ; Bello, Jacqueline A. ; Miller, Scott T. ; Vichinsky, Elliott P. ; DeBaun, Michael R. ; Guarini, Ludovico ; Zimmerman, Robert A. ; Younkin, Donald P. ; Gallagher, Dianne M. ; Kinney, Thomas R. / Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease. In: Blood. 2002 ; Vol. 99, No. 8. pp. 3014-3018.
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AU - Vichinsky, Elliott P.

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AU - Younkin, Donald P.

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