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

  • Jaroslaw Krejza
  • Michal Arkuszewski
  • Elias R. Melhem
Chapter
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

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.

Keywords

Stroke Ischemic stroke Intracerebral hemorrhage Sickle cell disease Computed tomography Magnetic resonance imaging Angiography Brain perfusion Cerebral venous thrombosis Emergency imaging Evidence-based imaging 

Notes

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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jaroslaw Krejza
    • 1
  • Michal Arkuszewski
    • 1
  • Elias R. Melhem
    • 2
  1. 1.Department of Neuroradiological SciencesInstitute of Innovative MedicineBialystokPoland
  2. 2.Department of Radiology and Diagnostic MedicineUniversity of Maryland School of MedicineBaltimoreUSA

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