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 Volume 67, Number 4, August 22, 2006
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NEUROLOGY 2006;67:572-574
© 2006 American Academy of Neurology

Transcranial Doppler ultrasonography in adults with sickle cell disease

N. Valadi, MD, G. S. Silva, MD, L. S. Bowman, BSc, D. Ramsingh, BSc, P. Vicari, MD, A. C. Filho, MD, A. R. Massaro, MD, A. Kutlar, MD, F. T. Nichols, MD and R. J. Adams, MD

From the Departments of Neurology (N.V., D.R., F.T.N., R.J.A.) and Hematology (A.K.) and School of Nursing (L.S.B.), Medical College of Georgia, Augusta; and Departments of Neurology (G.S.S., A.R.M.), Hematology (P.V.), and Infectious Diseases (A.C.F.), Federal University of São Paulo, Brazil.

Address correspondence and reprint requests to Dr Adams, Department of Neurology, Medical College of Georgia, 1429 Harper St., HF 1154, Augusta, GA 30912; e-mail: rjadams{at}mcg.edu

Background: Transcranial Doppler (TCD) is used to select children with sickle cell disease (SCD) for primary stroke prevention using regular blood transfusion. Whether it can also identify high stroke risk in adults with SCD is not known.

Methods: The authors examined 112 adult patients from two convenience population samples with SCD and 53 healthy control subjects to compare velocities in adults to those reported in children with SCD and to evaluate the influence of age and hematocrit on TCD.

Results: Adults with SCD had a higher mean time-averaged maximum mean velocity (110.9 ± 25.7 cm/s) compared with healthy controls (71.1 ± 12.0 cm/s), and the difference is approximately proportional to their anemia. No cases with velocities ≥200 cm/s (the threshold used in children for prophylactic treatment) were found in this sample.

Conclusions: Transcranial Doppler velocities in adults with sickle cell disease (SCD) are lower than those in children with SCD. Velocity criteria used in children cannot be used to stratify risk of stroke in adults.

Supported by a research grant from the Department of Neurology at the Medical College of Georgia.

Disclosure: The authors report no conflicts of interest.

Received July 21, 2005. Accepted in final form April 19, 2006.






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