Silent Cerebral Infarcts and Retinal changes in patients with Sickle cell Disease
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2016, Vol 3, Issue 2
Abstract
Background: CNS Complications of SCD include headache, seizures, cerebral venous thrombosis, and strokes. 11% and 20% of children with sickle cell anaemia will have overt and silent strokes respectively before their 18th birthday. 14-20% of SCD patients will develop Sickle cell Retinopathy. Aim of study: To look for SCI and Retinal changes in SCD children. Design- Prospective Cross sectional study. Participants- Below 16 yrs in a tertiary care hospital MYH/CNBC Indore, MP. Method: 40 children with SCD < 16 years admitted to Department of Paediatrics, MYH / CNBC Hospital, Indore, from December 2014 to October 2015 were selected and underwent MRI evaluation of brain and fundus examination. Result: Only 6 (15%) had presence of AV tortuosity with dialatation and 4 (10%) had presence of SCI (p>0.05) out of 40. All patients with SCI had presence of AV tortuosity (p=0.001). Statistical Analysis: Kruskal wallis test was applied. Conclusion: 40 children with SCD below the age of 16 years were included, 4(10%) had SCI and 6 (15%) had AV tortuosity and dilatation of retinal vessels. Asymptomatic children of SCD with unanticipated silent infarcts are highly predictive of subsequent clinical stroke and progressive silent infarction. So, these patients should receive frequent blood transfusion to decrease the level of HbS and Hydroxyurea to increase the HbF levels to prevent further subsequent clinical stroke. Also these children should undergo regular ophthalmic checkup for retinal changes and evaluation by MRI Brain for early detection of cerebral infarcts to prevent future occurrence of stroke.
Authors and Affiliations
Urvashi Channa, Sunil Arya, Hemant Jain, Vijay Bhaisare
Keywords
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- EP ID EP223325
- DOI 10.17511
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