A patient with sickle cell disease may develop neurologic findings consistent with cerebral ischemic events without ever manifesting the classic signs of stroke.
Patient selection: sickle cell disease
Risk factors:
(1) hypertension, which may be nocturnal
Clinical findings:
(1) none of the classic clinical signs of stroke
(2) presence of focal lesions in CT or MRI images (T2-weighted hyperintensities with corresponding T1-weighted hypointensities. Some use a size >= 3 mm in pediatric patients while others use >= 5 mm in adults).
Complications:
(1) confusion and/or cognitive deficits
(2) reduction in IQ and/or poor academic performance
(3) overt stroke
(4) cerebral aneurysms
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