Transcranial Doppler examination in patients with sickle cell anemia

Purpose: This study aimed to evaluate cerebral blood flow velocities using transcranial Doppler in children with sickle cell anemia, compared to healthy controls, in order to assess stroke risk among sickle cell patients. Materials and Methods: A total of 80 children participated in this prospective study, which included 40 children with sickle cell anemia (16 girls, 24 boys) and a control group of 40 healthy children (22 girls, 18 boys). The age range of participants was from 3 to 20 years. Cerebral blood flow measurements were performed using a transcranial Doppler (TCD) ultrasonography through the transtemporal and occipital acoustic windows. Time-averaged maximum mean velocity (TAMMV), Resistive Index (RI) and Pulsation Index (PI) of the Middle Cerebral Artery (MCA), Anterior Cerebral Artery (ACA), Posterior Cerebral Artery (PCA), vertebral arteries and basilar artery were recorded. Results: Children with sickle cell anemia demonstrated significantly elevated cerebral blood flow velocities in both the carotid and vertebrobasilar systems when compared to the control group. In the patient group, the mean±SD TAMMV values were 107.7±23.1 cm/s in the right MCA and 113.3±28.2 cm/s in the left MCA, whereas in the control group, these values were 77.9±16.4 cm/s and 78.1±14.8 cm/s, respectively. In three patients (7.5%) with sickle cell anemia, MCA TAMMV exceeded 170 cm/s. A negative correlation was observed between age and cerebral blood flow velocities. Additionally, RI and PI values for all examined vessels were significantly higher in the patient group compared to controls. Conclusion: Transcranial Doppler ultrasonography is a valuable, non-invasive modality for assessing stroke risk in children with sickle cell anemia. Routine screening using TCD may facilitate timely preventive interventions.