Screening with an ultrasound machine has proved highly successful in preventing stroke among children with sickle cell disease, by identifying children who are then preventively treated with blood transfusions. Over an eight-year period at The Children’s Hospital of Philadelphia, researchers found that the technique, transcranial Doppler ultrasonography (TCD), along with regular transfusions for children found to be at high risk, reduced stroke to one-tenth of the incidence found before TCD was introduced.

Childhood stroke has long been known to be a devastating complication of sickle cell disease, an inherited condition in which abnormal hemoglobin deforms red blood cells into sickle-shaped bodies that do not pass smoothly through blood vessels.

TCD is a noninvasive tool that uses ultrasound waves to measure the speed of blood flow in large vessels in the brain. An abnormally high speed is a marker of a narrowed vessel, and a sign of high risk for stroke.

The current study compared the rate of stroke in children with sickle cell disease in the eight years before Children’s Hospital began TCD screening with the eight years from 1998 to 2006. The researchers followed 475 children in the pre-TCD group and 530 children in the post-TCD group.

In reviewing patient records, the researchers measured overt strokes, other neurological events and indeterminate events — those that could not be classified based on available information. In the pre-TCD group, there were 21 patients with overt stroke, three with other neurological events and two with indeterminate events. In contrast, the post-TCD group had two patients with overt stroke, six with other neurological events and one with an indeterminate event.

Kwiatkowski’s collaborators were Kwaku Ohene-Frempong, M.D.; Kim Smith-Whitley, M.D.; Rebecca Ichord, M.D.; Henrietta Enninful-Eghan, M.S.; and Renee Moore, all of The Children’s Hospital of Philadelphia. The Comprehensive Sickle Cell Program at Children’s Hospital is funded through the Commonwealth of Pennsylvania Sickle Cell Program and numerous National Institutes of Health grants, and engages in basic and clinical research, public education, and a full clinical program for sickle cell disease.

About The Children’s Hospital of Philadelphia: The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu/.

Source: The Children’s Hospital of Philadelphia

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