Although transcranial Doppler ultrasound (TCUS or TCD) is recognized as a valuable predictor of stroke in children and adolescents with sickle cell disease, there are barriers to its use.

The presence of high cerebral blood flow on transcranial ultrasonography indicates elevated risk for stroke. The risk can be reduced by chronic transfusion therapy.


Barriers to transcranial ultrasonography:

(1) limited availability of radiology services

(2) distance to the radiology center

(3) provider not aware of the recommendation to perform

(4) poor care coordination between provider and radiology center

(5) provider belief that ultrasound screening will not impact outcomes

(6) inability to perform chronic blood transfusion therapy if TCUS screen positive

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