Children with Sickle Cell Anemia at Risk for Silent Strokes

November 12, 2012

Children with Sickle Cell Anemia at Risk for Silent Strokes

Children with sickle cell anemia are at risk of suffering from ‘silent’ stroke or silent cerebral infracts (SCI). Just why this is, is thought to be due to a combination of low hemoglobin levels and high blood pressure. For an unknown reason, boys with sickle cell anemia or SCA are more prone to silent strokes than girls with SCA. Silent strokes are a common complication of a child with SCA – no matter what the gender. 40% of all children with SCA will suffer a silent stroke by the time they reach age 14.

It can be difficult to determine if a child has suffered a silent stroke because there are no symptoms or signs such as with a regular symptomatic stroke or a transient ischemic attack or “mini-stroke.” Small parts of brain tissue die in areas related to memory, mood, vocabulary and bladder control. As they become adults, children that suffered silent strokes are more likely to suffer symptomatic strokes and have difficulties learning.

Study Specifics

The study looked at 814 children with SCA that were between the ages of 5 and 15. Over 250 of these children suffered a silent stroke. That’s about one-third of the 814 children studied. Each of the children in the study did not have a history of any types of stroke or seizure disorders (other conditions that can contribute to silent stroke.)

Data was compiled with the help of the international group, Silent Cerebral Infract Multi-Center Clinical Trial and the American group, the National Institute of Neurological Disorders and Stroke or NINDS. NINDS was initially interested in the study to see if children with sickle cell anemia would benefit from getting blood transfusions. The results of this huge study were published in the November 2011 issue of “Blood: The Journal of the American Hematology Society.”

About SCA

Sickle cell anemia is an incurable genetic blood condition that causes oxygen to not be transported efficiently through the body. Cells need oxygen in order to function. Red blood cells normally do the job of transporting this vital chemical throughout the body. Normal red blood cells are round and have normal amounts of hemoglobin, but in those with SCA, the cells are shaped like half-moons or sickles and contain very little hemoglobin. They can jam blood flow. The body becomes exhausted and ill due to lack of oxygen.

The body tries to get enough oxygen by raising blood pressure to force what little oxygen it does have through the blockades of sickle-shaped cells. This high blood pressure can help contribute to silent strokes. Children with SCA are often placed in special needs classes because they develop potentially crippling learning disabilities.

Going on From Here

This was the first large-scale study to link silent strokes and sickle cell anemia. The lead author of the study was Michael R. DeBaun, MD, MPH, also the director of a sickle cell treatment program at Vanderbilt University. Dr. DeBaun is now working on a study to see if a painkiller for SCA, hydroxurea, can help prevent silent strokes. Dr. DeBaun hopes that if silent strokes can be prevented in children with SCA, then they will not suffer from learning disabilities and their lives will significantly improve.

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