Transcranial doppler correlation with cerebral angiography in sickle cell disease

Cerebral infarction in sickle cell disease is associated with arterial narrowing or occlusions of intracranial arteries. Primary stroke prevention would be feasible if a noninvasive screening test could be developed to detect intracranial disease in patients before symptoms develop. To determine the...

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Bibliographic Details
Published in:Stroke (1970) 1992-08, Vol.23 (8), p.1073-1077
Main Authors: ADAMS, R. J, NICHOLS, F. T, FIGUEROA, R, MCKIE, V, LOTT, T
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anemia, Sickle Cell - complications
Anemia, Sickle Cell - diagnostic imaging
Anemias. Hemoglobinopathies
Arterial Occlusive Diseases - complications
Arterial Occlusive Diseases - diagnostic imaging
Biological and medical sciences
Cerebral Angiography
Cerebrovascular Disorders - complications
Cerebrovascular Disorders - diagnostic imaging
Child
Child, Preschool
Diseases of red blood cells
Female
Hematologic and hematopoietic diseases
Humans
Male
Medical sciences
Ultrasonography
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Summary:Cerebral infarction in sickle cell disease is associated with arterial narrowing or occlusions of intracranial arteries. Primary stroke prevention would be feasible if a noninvasive screening test could be developed to detect intracranial disease in patients before symptoms develop. To determine the sensitivity and specificity of transcranial Doppler in detecting significant (greater than or equal to 50% lumen diameter reduction) intracranial arterial lesions, we compared transcranial Doppler and cerebral angiography in a primarily young, symptomatic group of 33 patients (18 males and 15 females) with sickle cell disease. From a total of 34 examinations, transcranial Doppler detected significant abnormalities in 26 of 29 (sensitivity 90%, specificity 100%). Five were normal by both techniques. The transorbital examination detected abnormalities in two patients whose studies were otherwise unremarkable. Transcranial Doppler is sensitive and specific for the detection of arterial vasculopathy of sickle cell disease. Screening should include a transorbital examination of the distal internal carotid artery as well as examination using the transtemporal approach.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.23.8.1073