120 days is the healthy life span of a normal red blood cell. However, a patient infected with a sickle cell disease has an abnormal structure of its red blood cell. The RBCs can only survive for only 10 to 20 days for an SCD patient. In the current medical research, sickle cell disease is still incurable, but this condition can be treated to relieve its painful impact on one’s health.

Sickle cell disease can be associated with further health complications, especially if not treated with proper medications. It may further develop to organ damage, stroke, leg ulcers, acute chest syndrome, gallstones, pulmonary hypertension, blindness, and priapism.

In this article, we will focus on the relationship between sickle cell disease and stroke. Moreover, we’ll discuss when stroke can occur in patients with SCD.

How does the stroke develop in SCD patients?

During the early research studies, SCD patients suffered a stroke due to the blockage caused by the sickle cell RBCs. Thereafter, this blockage causes a restriction in the oxygen and blood flow to the brain, then symptoms this condition will start to occur.

However, modern studies have corrected this basic scientific principle and prove that large arteries are the primary reason for the strokes to SCD patients. Since the sickle RBCs is inelastic, these cells tend to clump along arterial walls causing damage to the blood vessels. The sickle cells also expose the passageway to gather more sickle RBC to narrow and restrict the vessels.

In addition, there is a 67% recurrence for patients with sickle cell disease to experience another stroke attack. Usually, it takes a 9-month gap before another attack will occur. According to the medical practitioners, the inverse relationship of the white blood cell count and hemoglobin levels causes the recurrence of the stroke at a higher risk. If you will recall, patients suffering from SCD may have increased white blood cells and a decrease hemoglobin level.

Early Stages of Stroke in Patients with SCD

There are two types of stroke for patients suffering from sickle cell disease, namely Overt and Silent cerebrovascular diseases. An overt stroke refers to a neurological condition that affects the brains and shows visible symptoms that lasted for more than 24 hours. It creates a T2, a FLAIR hyper intensity or a diffusion restriction on the MRI screening.

On the other hand, a silent stroke is a neurological condition that does not have any visible symptoms. Some patients who suffered a silent stroke are completely unaware that they have experienced this condition. This condition causes a lesion to the brain that can be detected through the neuroimaging MRI tests. This condition occurs in the frontal lobe of the brain and impairs the abilities of the individual.

According to the National Center for Biotechnology Information, cerebrovascular diseases occur as early as two years old among children. Around 11% of patients with SCD experienced a stroke at an early age of 20. However, silent cerebrovascular diseases are common among the youth than the overt strokes. Around 34% of the patients suffered silent strokes at the age of 14.

How to Predict Stroke for SCD patients?

In recent medical studies, the children are the most vulnerable patients to diagnose with stroke. Based on the research and medical history, these circumstances and symptoms may give rise to the cerebrovascular incidents for patients suffering from a sickle cell disease.

• Traumatic experience
• Increase WBC count
• Sleep Apnea or Snoring
• Seizures
• Increase blood pressure
• Decrease hemoglobin levels
• Infections in the nervous system
• Increase frequency of the acute chest syndrome
• A recent transient ischemic attack
• Abnormal results of the Transcranial Doppler
• Increase cerebral blood flow pressure

It is important to take note of these early signs and symptoms in order to prevent the occurrence of the stroke. You should find doctors to consult your overall health conditions and undergo neuroimaging lab tests to determine any symptoms of cerebrovascular diseases.

What is a Transcranial Doppler Ultrasonography?

This laboratory instrument measures the velocity of the cerebral blood flow circulating around the intracranial arteries. Using the Transcranial Doppler Ultrasonography, it can detect the patients with a higher risk of cerebral infarction. Generally, results are assessed whether normal or abnormal based on the highest velocity of the blood flow located in the middle cerebral artery. An abnormal velocity ranges around equal to or more than the 170cm per second.

The transcranial non-invasive ultrasound reads inaudible sound waves being transmitted through the skull’s tissues. The sound waves display a mirror effect of the blood cells moving within the vessels.
It allows the radiologist to interpret the direction and speed of the sound waves recorded on the computer screen.

This device is a key to better understand the risks of the stroke for SCD patients. Moreover, it provides a predictive measure in order to conduct proper medical examinations and prevent the occurrence of stroke.

Published: 2019-02-06 16:44:31