Sickle‐cell disease stroke throughout life: A retrospective study in an adult referral center

Abstract Strokes are one of the most severe complications of sickle‐cell disease. Most studies have been restricted to children with sickle‐cell disease. To better understand the characteristics and follow‐up of strokes occurring from childhood to adulthood, we undertook a retrospective cohort study of 69 stroke patients among the 2,875 patients consulting at the French Adult Sickle‐Cell Disease Referral Center. Between 1970 and 2008, they had experienced 104 strokes: 80 ischemic, 22 hemorrhagic and 2 intracranial sinus thromboses. Coma and/or fatal outcomes underscored the severity of strokes in sickle‐cell disease patients. Hemorrhagic strokes occurred mostly in adults and carried a higher risk of death than ischemic stroke. The mechanisms underlying sickle‐cell disease associated strokes were reevaluated and etiologies were determined for first stroke and recurrences, in childhood and adulthood. Sickle‐cell disease vasculopathy concerned only SS patients and remains their most frequent stroke etiology. Cardioembolism, vaso‐occlusive crisis and triggering factors were other etiologies identified in adults. Recurrences occurred in 19 SS patients only after a first ischemic stroke. SC patients' strokes occurred in adulthood and were associated with cardiovascular risk factors. Our findings provide novel information about cerebrovascular pathologies throughout the lives of sickle‐cell disease patients and suggest the need for different diagnostic and therapeu...
Source: American Journal of Hematology - Category: Hematology Authors: Tags: Research Article Source Type: research