Cerebral hyperemia, stroke, and transfusion in sickle cell disease
- PMID: 2927641
- DOI: 10.1212/wnl.39.3.344
Cerebral hyperemia, stroke, and transfusion in sickle cell disease
Abstract
To investigate cerebral hemodynamics in sickle cell disease (SCD), we used the 133Xenon inhalation technique of quantifying cerebral blood flow (CBF) in 67 patients. Clinical examinations and cerebral magnetic resonance imaging also were performed in all patients. Compared with age-matched healthy controls, CBF was elevated by 68% in patients, and inversely related to hematocrit. An experimental index of cerebral blood volume, pr4, was also elevated in the patients in a similar manner. Cerebral blood volume was positively correlated to CBF in SCD patients but not in controls. History of stroke and current neurologic symptoms were associated with lower flow and higher cerebral blood volume. Transfusion therapy reduced the hyperemia, the reduction being greater than expected by hematocrit elevation alone. These findings document a vasodilatory hyperemia in SCD. This dilatation may be a risk factor for ischemic distal-field infarctions, as visualized by MRI, due to a limitation of cerebrovascular reserve capacity.
Similar articles
-
The severity of anaemia depletes cerebrovascular dilatory reserve in children with sickle cell disease: a quantitative magnetic resonance imaging study.Br J Haematol. 2017 Jan;176(2):280-287. doi: 10.1111/bjh.14424. Epub 2016 Dec 1. Br J Haematol. 2017. PMID: 27905100
-
Effects of total hemoglobin and hemoglobin S concentration on cerebral blood flow during transfusion therapy to prevent stroke in sickle cell disease.Stroke. 1994 Aug;25(8):1688-92. doi: 10.1161/01.str.25.8.1688. Stroke. 1994. PMID: 8042222
-
Stenosis or hyperperfusion in sickle cell disease--ultrasound assessment of cerebral blood flow volume.Ultrasound Med Biol. 2012 Aug;38(8):1333-8. doi: 10.1016/j.ultrasmedbio.2012.04.003. Epub 2012 Jun 12. Ultrasound Med Biol. 2012. PMID: 22698503
-
Big strokes in small persons.Arch Neurol. 2007 Nov;64(11):1567-74. doi: 10.1001/archneur.64.11.1567. Arch Neurol. 2007. PMID: 17998439 Review.
-
How I manage cerebral vasculopathy in children with sickle cell disease.Br J Haematol. 2015 Sep;170(5):615-25. doi: 10.1111/bjh.13477. Epub 2015 May 5. Br J Haematol. 2015. PMID: 25944412 Review.
Cited by
-
Hypoxic adaptation during development: relation to pattern of neurological presentation and cognitive disability.Dev Sci. 2006 Jul;9(4):411-27. doi: 10.1111/j.1467-7687.2006.00507.x. Dev Sci. 2006. PMID: 16764614 Free PMC article. Review.
-
Differential cerebral hemometabolic responses to blood transfusions in adults and children with sickle cell anemia.J Magn Reson Imaging. 2019 Feb;49(2):466-477. doi: 10.1002/jmri.26213. Epub 2018 Oct 15. J Magn Reson Imaging. 2019. PMID: 30324698 Free PMC article.
-
Evaluation of SWI in children with sickle cell disease.AJNR Am J Neuroradiol. 2014 May;35(5):1016-21. doi: 10.3174/ajnr.A3794. Epub 2013 Nov 21. AJNR Am J Neuroradiol. 2014. PMID: 24263696 Free PMC article.
-
Impairment of Cerebrovascular Hemodynamics in Patients With Severe and Milder Forms of Sickle Cell Disease.Front Physiol. 2021 Apr 20;12:645205. doi: 10.3389/fphys.2021.645205. eCollection 2021. Front Physiol. 2021. PMID: 33959037 Free PMC article.
-
Precursors of executive function in infants with sickle cell anemia.J Child Neurol. 2013 Oct;28(10):1197-202. doi: 10.1177/0883073812453495. Epub 2012 Aug 1. J Child Neurol. 2013. PMID: 22859700 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical