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Evidence-Based Emergency Neuroimaging in Children and Adults with Sickle Cell Disease and Symptoms of Stroke

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Evidence-Based Emergency Imaging

Part of the book series: Evidence-Based Imaging ((Evidence-Based Imag.))

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Abstract

Stroke is a major cause of morbidity in children with sickle cell disease. There is a broad spectrum of acute presentations of both ischemic and hemorrhagic strokes. The optimal medical management of patients with acute ischemic stroke is not yet determined based on randomized clinical trials. Non-contrast computed tomography (CT) remains the initial test of choice for emergency brain assessment of patients with acute stroke. Magnetic resonance imaging (MRI) may be as accurate as CT for the detection of acute hemorrhage in patients presenting with acute stroke symptoms and is more accurate than CT for the detection of ischemic stroke and chronic intracerebral hemorrhage. CT angiography, CT perfusion, MR angiography, and MR venography can be added to emergency CT to detect large arterial vasculopathy, perfusion defects, and cerebral venous thrombosis; however, there is no sufficient evidence to justify their emergency use.

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Acknowledgments

The authors would like to acknowledge the work of Drs. Maciej Swiat and Maciej Tomaszewski, their coauthors in previous chapters [“Sickle Cell Disease and Stroke” in Evidence-Based Imaging in Pediatrics (Medina LS et al., eds; Springer Science; 2010); “Pediatric Sickle Cell Disease and Stroke” in Evidence-Based Imaging (Medina LS et al., eds; Springer Science; 2011); “Sickle Cell Disease and Stroke: Evidence-Based Neuroimaging” in Evidence-Based Neuroimaging (Medina LS et al., eds; Springer Science 2013)], which served as starting points for this current chapter.

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Authors and Affiliations

  1. Department of Neuroradiological Sciences, Institute of Innovative Medicine, Bialystok, Poland

    Jaroslaw Krejza & Michal Arkuszewski

  2. Department of Radiology and Diagnostic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Elias R. Melhem

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  1. Jaroslaw Krejza
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Correspondence to Jaroslaw Krejza .

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Editors and Affiliations

  1. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Aine Kelly

  2. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Paul Cronin

  3. Department of Diagnostic, Interventional, and Pediatric Radiology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

    Stefan Puig

  4. Department of Radiology, University of Kentucky Children’s Hospital, Lexington, KY, USA

    Kimberly E. Applegate

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Krejza, J., Arkuszewski, M., Melhem, E.R. (2018). Evidence-Based Emergency Neuroimaging in Children and Adults with Sickle Cell Disease and Symptoms of Stroke. In: Kelly, A., Cronin, P., Puig, S., Applegate, K. (eds) Evidence-Based Emergency Imaging. Evidence-Based Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-67066-9_33

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