Biomedical Research

Background: Sickle cell disease is one of the most common inherited diseases in Sudan, and it is the most common cause of childhood stroke, occurring with the highest frequency before the age of 6 years. Children with SCD who are developing high stroke risk can be detected months to years before the stroke using non-invasive transcranial Doppler ultrasonography providing a means of selecting and prophylactically treating SCA children at highest risk. Objectives: This study aims to evaluate transcranial Doppler abnormalities in children with sickle cell disease in El-Obied specialized children hospital. Materials and methods: This is a cross sectional study done on the 119 patients who attended the sickle cell clinic in El-Obied specialized children hospital during time period from December 2016 to February 2017, ages from 2-18 years was included, when patients does not have recent stroke symptoms, blood flow velocities was measured in both proximal internal carotid and middle cerebral arteries using nonimaging Doppler method, TAMVs was recorded along with hemoglobin concentration and of the patients. Results: 0% of the study population had middle cerebral artery velocity higher than 200 cm/s, also no high conditional velocity (170-199 cm/s) was recorded so no patient was at high risk to develop stroke. 20.1% of patients showed low velocities in one or both middle cerebral arteries, as well, 4.2% had abnormal middle cerebral arteries interhemispheric ratio, 4.2% of study population showed absent flow in one of their middle cerebral arteries, reflecting previous occlusion. 4.2% had poor temporal window. It was difficult to measure the velocity in one of the 4 vessels in 5.9% of the patient due to uncooperativeness. There was statistically significant relationship between hemoglobin concentration and blood velocity in the left middle cerebral artery. Conclusion: Despite the international recommendations, using TCD as stroke screening tool in children with sickle cell disease in Sudan is still not a well-known practice. Successful strategies to improve TCD screening rates must be encouraged in all health care institutions.

Author(s): Walaa Ismail Musa Ismail, Mustafa Elnour, Alam Eldin Musa Mustafa
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