A patient with sickle cell disease is at increased risk for stroke. Ohene-Frempong et al identified risk factors associated with a cerebrovascular accident in these patients. The authors are from multiple universities in the United States participating in the Cooperative Study of Sickle Cell Disease.


Patient selection: sickle cell disease (SS, SC, sickle thalassemia)


Types of cerebrovascular accidents:

(1) infarctive

(2) hemorrhagic


Risk factors for infarctive stroke (relative risk in Table 5):

(1) anemia (low steady-state hemoglobin concentration)

(2) elevated systolic blood pressure

(3) history of transient ischemic attacks (TIA)

(4) recent episode of acute chest syndrome (within past 2 weeks)

(5) high rate of acute chest syndrome (events per year)


Risk factors for hemorrhagic stroke (relative risk in Table 5):

(1) anemia

(2) leukocytosis


Hemorrhagic strokes were associated with a 26% mortality rate in the 2 weeks afterwards. Infarctive strokes were not associated with significant mortality.


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