Serious neurologic complication of sickle cell anemia

Serious neurologic complication of sickle cell anemia

What is the most serious neurologic complication of sickle cell anemia? 

Ischemic stroke, often affecting patients in childhood or adolescence, is the most frequent serious sequela of a vascular crisis in sickle cell disease.

Intimal hyperplasia and stenosis of proximal cerebral vessels have been described in the pathogenesis for medium-vessel and large-vessel stroke in these patients.

Hyperventilation (with associated vasoconstriction) is thus a common precipitating event for stroke in the young patient with sickle cell disease.

Recurrence rates for stroke in patients with sickle cell disease exceed 67%. Intracranial hemorrhage may also be seen in patients with sickle cell disease.

Rupture of intracranial aneurysms is the usual cause for ICH in affected individuals.

Other neurologic complications of sickle cell anemia include silent cerebral infarcts, which occur in one-fourth of pediatric sickle cell patients before the age of 6 and one-third of pediatric sickle cell patients before the age of 14.

These silent infarcts can be significantly detrimental to cognitive development and academic performance.

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