Patients with sickle cell disease are frequently excluded from the benefits of transcranial doppler screening for the risk of stroke despite extensive and compelling evidence
Document title: Patients with sickle cell disease are frequently excluded from the benefits of transcranial doppler screening for the risk of stroke despite extensive and compelling evidence
Journal: Arquivos de neuro-psiquiatria
Database: PERIÓDICA
System number: 000405873
ISSN: 0004-282X
Authors: 1
2
1
3
4
1
Institutions: 1Universidade Federal de Sao Paulo, Departamento de Neurologia, Sao Paulo. Brasil
2Obafemi Awolowo University, Department of Pediatrics and Child Health, Ife, Osun. Nigeria
3Universidade Federal de Sao Paulo, Departamento de Pediatria, Sao Paulo. Brasil
4Universidade Federal de Sao Paulo, Departamento de Oncologia Clinica e Experimental, Sao Paulo. Brasil
Year:
Season: Ene
Volumen: 75
Number: 1
Pages: 15-19
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Aplicado, analítico
English abstract Transcranial doppler (TCD) is a strategic component of primary stroke prevention in children with sickle cell disease (SCD). This study was conducted to examine the TCD characteristics of children with SCD in nine different medical centers in Brazil. Methods: Transcranial doppler was performed in accordance with the Stroke Prevention Trial in Sickle Cell Anemia Protocol. Results: Of the 396 patients, 69.5% had homozygous SS hemoglobin. The TCD result was abnormal in 4.8%, conditional in 12.6%, inadequate in 4.3% and abnormally low in 1% of patients. The highest mean flow velocities were 121±23.83cm/s and 124±27.21cm/s in the left and right middle cerebral artery respectively. A total of 28.8% patients (mean age 9.19±5.92 years) were evaluated with TCD for the first time. Conclusions: The SCD patients were evaluated with TCD at an older age, representing an important missed opportunity for stroke prevention. Since TCD screening in patients with SCD is important to detect those at high risk for stroke, it is recommended that this screening should be made more readily available
Portuguese abstract Doppler transcraniano (DTC) é um componente estratégico da prevenção primária do acidente vascular cerebral (AVC) em crianças com doença falciforme (DF). Este estudo foi realizado para examinar as características do DTC de crianças com DF em nove centros médicos diferentes no Brasil. Métodos: DTC foi realizado de acordo com o protocolo de Stroke Prevention Trial in Sickle Cell Anemia Protocol (STOP). Resultados: Dos 396 pacientes avaliados, 69,5% eram homozigotos para hemoglobina SS. DTC foi anormal em 4,8%, condicional em 12,6%, inadequado em 5,3% e anormalmente baixo em 1%. As máximas velocidades de fluxo médio foram 121 ± 23,83cm/s e 124 ± 27,21 cm/s nas artérias cerebrais media esquerda e direita, respectivamente. Um total de 28,8% dos pacientes (média de 9,19 ± 5,92 anos) foram avaliados com o DTC pela primeira vez. Conclusões: Pacientes com DF foram avaliados com DTC numa idade considerada avançada, o que representa uma importante oportunidade perdida para a prevenção de AVC nessa população. Uma vez que a triagem com DTC em pacientes com DF é essencial para detectar aqueles com alto risco de AVC, recomenda-se que essa triagem seja amplamente disponível no país
Disciplines: Medicina
Keyword: Diagnóstico,
Neurología,
Anemia falciforme,
Ultrasonido Doppler,
Doppler transcraneal,
Accidentes cerebrovasculares,
Prevención
Keyword: Medicine,
Diagnosis,
Neurology,
Sickle cell disease,
Doppler ultrasound,
Transcranial Doppler,
Cerebrovascular accidents,
Prevention
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