Background
The role of transcranial Doppler (TCD) ultrasonography in identifying children with
sickle cell anemia (SCA) at risk for stroke is well known; however, the major studies
that evaluated TCD velocities in children with SCA did not report posterior circulation
evaluation data. The objective of our study was to describe the pattern of blood flow
velocities in the posterior circulation of patients with SCA and to examine their
relationship with findings on magnetic resonance imaging (MRI)/magnetic resonance
angiography (MRA).
Methods
All adult patients with SCA followed in the outpatient clinic of our hospital were
evaluated with TCD and MRI/MRA. The highest velocities of the middle cerebral arteries
or internal carotid arteries were taken as the time-averaged maximum mean (TAMM) velocity
for each patient and the maximum mean flow velocities in the posterior circulation
(TAMMpost) were recorded.
Results
Fifty-six patients with SCA and 56 healthy nonanemic volunteers were evaluated. The
mean TAMMpost in the basilar, vertebral, and posterior cerebral arteries (PCAs) were
significantly higher among cases than controls (P < .01). In patients with SCA, the TAMMpost in all posterior circulation arteries
had a positive correlation with TAMM. Only 1 patient with stenosis in the posterior
circulation (right PCA) was identified.
Conclusion
We found a low frequency of stenosis but high blood flow velocities in the posterior
circulation in patients with SCA. The role of increased TCD velocities in the posterior
circulation upon stroke risk in patients with SCA should be further examined.
Key Words
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Article info
Publication history
Published online: January 08, 2016
Accepted:
November 5,
2015
Received in revised form:
September 8,
2015
Received:
May 18,
2015
Footnotes
The present study was conducted at Universidade Federal de São Paulo.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.007
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
