Some patients with sickle cell disease (SCD) may develop cognitive impairment.

Risk factors for cognitive impairment:

(1) focal brain injury (identified on MR imaging) or silent cerebral infarct

(2) diffuse brain injury

(3) anemia with low hematocrit, which may be associated with elevated LDH

(4) advancing age


Focal brain injury may include lacunar infarcts.


Silent cerebral infarction may be associated with white matter hyperintensities on MRI.


Functions affected may include:

(1) verbal intelligence

(2) verbal comprehension

(3) distractibility

(4) overall intelligence

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