Posterior Circulation Evaluation in Patients with Sickle Cell Anemia

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• 作者：Samuel Ademola Adegoke ; MD ; MPH^* ; ^&dagger ; ; Maria Stella Figueiredo ; MD ; PhD^&dagger ; ; Perla Vicari ; MD ; PhD^&dagger ; ; Henrique Carrete Jr. ; MD ; PhD^&Dagger ; ; Marcos Hideki Idagawa ; MD^&Dagger ; ; Ayrton Roberto Massaro ; MD ; PhD^§ ; ; Gisele Sampaio Silva ; MD ; MPH PhD^‖ ; ^¶ ; ; ^{giselesampaio@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sickle cell anemia ; transcranial Doppler ; posterior circulation ; magnetic resonance imaging ; stroke ; intracranial stenoses
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：25
• 期：3
• 页码：717-721
• 全文大小：183 K

文摘

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.