SCREENING BY TRANSCRANIAL DOPPLER ULTRASONOGRAPHY OF MIDDLE CEREBRAL ARTERY IN CHILDREN WITH SICKLE CELL DISEASE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 5
Abstract
BACKGROUND Sickle cell disease is a common haematological disorder. The prevalence of this disease varies from 2% to 34% in our country. There is neovascularisation and sickle red cell induced inflammation of the endothelium of vessels resulting in narrowing of the lumen of vessels. This occlusive vasculopathy results in increased blood flow velocities in major intracranial vessels in children with sickle cell disease. This predisposes them to ischaemic and haemorrhagic infarcts in brain resulting in strokes. TCD (Transcranial Doppler) is a useful radiological tool to screen the children with increased mean blood flow velocities in distal internal carotid artery and proximal middle cerebral artery. This study was aimed to assess the blood flow velocities in left and right middle cerebral arteries of children with sickle cell disease and to compare these velocities with a control group of normal children, matching their sex and age profile. MATERIALS AND METHODS This is a hospital-based comparative study done at Gitam’s Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh and Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram district, Andhra Pradesh. Purposive and convenient sampling technique was used for data collection. The study was done on 20 children in whom sickle cell disease was confirmed by electrophoresis and on same number of age and sex matched controls. The velocities thus obtained were stratified according to the classification based on STOP (Stroke Prevention Trial 1) study and analysed. Statistical analysis of the data was done by using SPSS software version 16. A p value of less than 0.05 was taken as significant. RESULTS Mean blood flow velocities in middle cerebral arteries were significantly higher in our cases when compared to control group. It was observed that 17 out of the 20 children with sickle cell disease had elevated velocities in the range of 170 - 199 cm/s, 1 child had a velocity of less than 170 cm/s and 2 children had mean velocities of more than 200 cm/s. CONCLUSION Transcranial Doppler sonography is an inexpensive, non-invasive imaging modality for screening the patients with sickle cell disease, to detect children who are at risk for stroke.
Authors and Affiliations
Kanaka Durga Prasad Bhamidipaty, Madhavi Chamarthi, Pravallika Isireddy
Keywords
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- EP ID EP368920
- DOI 10.14260/jemds/2018/154
- Views 77
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