Featured Research

from universities, journals, and other organizations

'Silent' stroke risk factors for children with sickle cell anemia

Date:
November 18, 2011
Source:
American Society of Hematology
Summary:
Factors such as low hemoglobin levels, increased systolic blood pressure, and male gender are linked to a higher risk of silent cerebral infarcts, or silent strokes, in children with sickle cell anemia, according to results from a large, first-of-its-kind study.

Factors such as low hemoglobin levels, increased systolic blood pressure, and male gender are linked to a higher risk of silent cerebral infarcts (SCIs), or silent strokes, in children with sickle cell anemia (SCA), according to results from a large, first-of-its-kind study published online November 17 in Blood, the Journal of the American Society of Hematology (ASH).

Silent strokes are the most common form of neurological injury found in SCA, with more than 25 percent of children with the disorder suffering a SCI by age six,1 and nearly 40 percent by age 14.2 Strokes occur in patients with SCA as a result of low hemoglobin levels in the blood. Because hemoglobin is responsible for carrying oxygen to the blood, the body compensates for low hemoglobin levels by increasing blood flow to the brain, raising patients' risk for brain injury, including these silent strokes.

"Young patients with a history of silent strokes have an increased risk of future overt strokes and new or increasingly severe silent stroke-related events, and have poorer cognitive function than children with sickle cell disease who have normal brain MRIs," said Michael R. DeBaun, MD, MPH, first author and initiator of the study and Director of the Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease at Vanderbilt University. "Children with silent strokes have a much higher risk of poor academic performance, and over the long term, we see a higher proportion of these young adults requiring special education or being retained in school."

While silent strokes have been well documented in older adults, there has been limited research available to support clinical risk factors for silent strokes in children with SCA. In order to assess whether previously identified risk factors for silent strokes in the general population -- low hemoglobin, high systolic blood pressure, and male gender -- were also associated with an increased risk of silent strokes in patients with SCA, investigators analyzed data from the international, multicenter Silent Cerebral Infarct Multi-Center Clinical Trial (SIT Trial). The SIT Trial, which was supported by the National Institutes of Health (NIH) and the National Institute of Neurological Disorders and Stroke (NINDS), was designed to determine the efficacy of blood transfusion therapy for prevention of recurrent silent stroke events in participants with SCA.

In this cross-sectional study, investigators evaluated clinical history and baseline laboratory values and performed brain MRIs (to confirm silent stroke) in 814 children with SCA between the ages of 5 and 15 years with no history of overt stroke or seizures. Results from the data analysis showed that silent strokes occurred in one-third (251 of 814) of SCA patients enrolled in the trial. Further analysis demonstrated that lower concentrations of hemoglobin, higher baseline systolic blood pressure, and male gender were associated with a significantly increased risk of silent stroke.

"This study confirms our original hypothesis that risk factors for silent strokes in the general population are also risk factors for pediatric patients with sickle cell anemia," said Dr. DeBaun, also the JC Peterson Endowed Chair in the Department of Pediatrics at Vanderbilt University. "With these results, we can focus our research efforts on strategies to prevent these silent strokes in children with SCA."

Dr. DeBaun and colleagues are currently conducting additional research to determine if hydroxyurea, a treatment traditionally used to manage the pain episodes that occur with SCA, can also be used to prevent silent strokes in infants.

  1. Kwiatkowski JL, Zimmerman RA, Pollock AN, et al. Silent infarcts in young children with sickle cell disease. Br J Haematol. 2009;146:300-305.
  2. Bernaudin F, Verlhac S, Arnaud C, et al. Impact of early transcranial Doppler screening and intensive therapy on cerebral vasculopathy outcome in a newborn sickle cell anemia cohort. Blood. 2011;117:1130-1140; quiz 1436.

Story Source:

The above story is based on materials provided by American Society of Hematology. Note: Materials may be edited for content and length.


Journal Reference:

  1. M. R. DeBaun, S. A. Sarnaik, M. J. Rodeghier, C. P. Minniti, T. H. Howard, R. V. Iyer, B. Inusa, P. T. Telfer, M. Kirby-Allen, C. T. Quinn, F. Bernaudin, G. Airewele, G. M. Woods, J. A. Panepinto, B. Fuh, J. K. Kwiatkowski, A. A. King, M. M. Rhodes, A. A. Thompson, M. E. Heiny, R. C. Redding-Lallinger, F. J. Kirkham, H. Sabio, C. E. Gonzalez, S. L. Saccente, K. A. Kalinyak, J. J. Strouse, J. M. Fixler, M. O. Gordon, J. P. Miller, R. N. Ichord, J. F. Casella. Associated risk factors for silent cerebral infarcts in sickle cell anemia: low baseline hemoglobin, gender and relative high systolic blood pressure. Blood, 2011; DOI: 10.1182/blood-2011-05-349621

Cite This Page:

American Society of Hematology. "'Silent' stroke risk factors for children with sickle cell anemia." ScienceDaily. ScienceDaily, 18 November 2011. <www.sciencedaily.com/releases/2011/11/111117141243.htm>.
American Society of Hematology. (2011, November 18). 'Silent' stroke risk factors for children with sickle cell anemia. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2011/11/111117141243.htm
American Society of Hematology. "'Silent' stroke risk factors for children with sickle cell anemia." ScienceDaily. www.sciencedaily.com/releases/2011/11/111117141243.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
Can Watching TV Make You Feel Like A Failure?

Can Watching TV Make You Feel Like A Failure?

Newsy (July 24, 2014) A study by German researchers claims watching TV while you're stressed out can make you feel guilty and like a failure. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins