The spectrum of brain MR abnormalities in sickle-cell disease: a report from the Cooperative Study of Sickle Cell Disease.

Published

Journal Article

PURPOSE: To define the spectrum of abnormalities in sickle-cell disease, including infarction, atrophy, and hemorrhage, that are identified by brain MR imaging. METHODS: All MR studies included T1, T2, and intermediate pulse sequences. Images were interpreted without knowledge of the clinical history or neurologic examination findings. Brain MR imaging was performed in 312 children with sickle-cell disease. RESULTS: Seventy patients (22%) had infarction/ischemia and/or atrophy, infarction/ischemia was noted in 39 children (13%) who had no history of a stroke (the "silent" group). The prevalence rates for silent lesions were 17% for sickle-cell anemia and 3% for hemoglobin sickle-cell disease. For patients with sickle-cell anemia and a history of cerebrovascular accident, infarction/ischemia lesions typically involved both cortex and deep white matter, while silent lesions usually were confined to deep white matter. Within the age range studied, the prevalence of infarction/ischemia did not increase significantly with age, although older patients with lesions had more lesions than did younger patients with lesions. CONCLUSIONS: Brain MR imaging showed infarction/ischemia in the absence of a recognized cerebrovascular accident in 13% of patients. The prevalence of these lesions did not increase significantly between the ages of 6 and 14 years, suggesting that lesions are present by age 6. However, the increase in the average number of lesions per patient with age may indicate progressive brain injury.

Full Text

Duke Authors

Cited Authors

  • Moser, FG; Miller, ST; Bello, JA; Pegelow, CH; Zimmerman, RA; Wang, WC; Ohene-Frempong, K; Schwartz, A; Vichinsky, EP; Gallagher, D; Kinney, TR

Published Date

  • May 1996

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 965 - 972

PubMed ID

  • 8733975

Pubmed Central ID

  • 8733975

Electronic International Standard Serial Number (EISSN)

  • 1936-959X

International Standard Serial Number (ISSN)

  • 0195-6108

Language

  • eng