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Sickle Cell Disease and Stroke

  • Akifumi Fujita
  • Chie Asai
  • Yu-Ming Chang
  • Nadja Kadom
  • Martin H. Steinberg
  • Naoko Saito
  • Osamu Sakai
Reference work entry

Abstract

Sickle cell disease (SCD) is a hereditary disorder that is so named for the presence of characteristic malformed sickle-shaped red blood cells (RBCs). These abnormal RBCs are short-lived and can also cause vaso-occlusion throughout the body, which may lead to ischemia and infarcts in multiple organ systems. Neurovascular complications of SCD include cerebral vasculopathy, such as stroke and neurocognitive deficits, which are significant causes of morbidity and mortality in both children and adults. In current clinical practice, various conventional imaging tools, such as computed tomography (CT), magnetic resonance imaging (MRI), and catheter angiogram, still play an important role in diagnosis and follow-up of neurovascular complications of SCD. Ultrasounds, including transcranial Doppler (TCD) ultrasound, are useful in screening for intra- and extracranial vasculopathy. Advanced imaging techniques, such as diffusion tensor imaging (DTI), perfusion imaging, MR spectroscopy, quantitative MRI (qMRI), and nuclear medicine such as single-photon emission computed tomography (SPECT) and positron emission tomography (PET), are emerging as diagnostic tools in the evaluation of SCD.

In this chapter, a brief overview of the etiology, classification, pathophysiology, epidemiology, clinical manifestation, and treatment of SCD is provided. The complications of SCD seen across the spectrum of conventional to advanced imaging modalities are also illustrated and discussed. The focus is on neurovascular complications and its management, but there will also be a discussion of posterior reversible encephalopathy syndrome, craniofacial osseous complications, and inner ear complications, which may be encountered in the daily neuroradiology practice.

Keywords

Sickle cell disease (SCD) Quantitative MRI (qMRI) Diffusion tensor imaging (DTI) Perfusion imaging MR spectroscopy (MRS) Vasculopathy Vaso-occlusion Hemolytic anemia Stroke Ischemic stroke Hemorrhagic stroke Silent cerebral infarct (SCI) Cerebral fat embolism Moyamoya syndrome Posterior reversible encephalopathy syndrome (PRES) Bone infarction Osteomyelitis Labyrinthine hemorrhage (LH) Labyrinthitis ossificans (LO) Arterial spin labeling (ASL) Positron emission tomography (PET) Single-photon emission computed tomography (SPECT) Transcranial Doppler (TCD) 

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Akifumi Fujita
    • 1
  • Chie Asai
    • 1
  • Yu-Ming Chang
    • 1
  • Nadja Kadom
    • 1
  • Martin H. Steinberg
    • 2
  • Naoko Saito
    • 3
  • Osamu Sakai
    • 1
    • 4
    • 5
  1. 1.Departments of RadiologyBoston University, Boston Medical CenterBostonUSA
  2. 2.Departments of Medicine, Pediatrics, and Pathology and Laboratory MedicineBoston University, Boston Medical CenterBostonUSA
  3. 3.Department of Diagnostic RadiologySaitama Medical University International Medical CenterSaitamaJapan
  4. 4.Department of Otolaryngology – Head and Neck SurgeryBoston University, Boston Medical CenterBostonUSA
  5. 5.Department of Radiation OncologyBoston University, Boston Medical CenterBostonUSA

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