Sickle Cell Anemia, Stroke, and Transcranial Doppler Studies

In the 40 years after the first description of sickle cell disease in 1910, roughly a paper per decade described neurologic complications, including stroke, and attributed them to the likes of anemia, fever, meningitis, hemorrhage, and even cerebral fat embolism. Improvements in the diagnosis of sickle cell anemia allowed larger cohorts to be studied, and new techniques of brain imaging, first CT scans¹ and then magnetic resonance imaging,^{2 , 3} have amply confirmed that stroke is a major problem in sickle cell disease, with a prevalence ranging from 5.5 percent¹ to 17 percent.⁴ Infarction occurs mainly in younger patients, and hemorrhage in . . .