Assessment of the risk of stroke in children with sickle cell anemia using transcranial doppler ultrasound with imaging in Northwestern Nigeria

Background: Stroke is a major cause of morbidity and mortality affecting about 10% of patients with sickle cell anemia (SCA). Transcranial Doppler (TCD)  ultrasonography helps to identify children with SCA who are at an increased risk for stroke. This study aimed to determine the risk of stroke in children  with SCA in steady state using Transcranial Doppler with Imaging (TCDI) scan abnormalities and the prevalence of TCDI scan abnormalities among  children with SCA in northern Nigeria. Materials and Methods: We conducted acomparative study among 240 persons with SCA who attended a pediatric sickle cell clinic in northern Nigeria  and were in steady state condition. We performed a transcranial ultrasound examination and collected blood samples to perform full blood counts and  hemoglobin electrophoresis. Results: Abnormal velocities were obtained in 11 (9.3%) children with SCA; while 16 (13.6%) had conditional velocities and 89 (76.7%) of those had normal  velocities in one or more of the four vessels studied. Most of the children in the control group 116 (96.7%) had normal velocities and the difference  between the groups was not statistically significant (χ 2 = 0.59, p > 0.05). Conclusion: The use of TCDI sonography to predict the risk of stroke should be  included in the standard of care in children with SCA in Nigeria and should be included in routine evaluation of disease severity in children with SCA