Silent cerebral infarcts in children with sickle cell anemia

ABSTRACT

Children with sickle cell anemia [SCA] are at high risk for neurologically overt cerebral infarcts associated with stroke and neurologically silent cerebral infarcts [SCI] correlated with neuropsychometric deficit. The purpose of this study was to determine the incidence of SCI among patients with SCA and to detect the risk factors for its occurrence and to evaluate the effect of SCI on neurocognitive functions. We studied 20 patients with SCA clinically and laboratory, then MR1 brain to detect cerebral infarctions was performed to all patients and neuropsychological evaluation using Wechseler Intelligence Scale-far children, 3[rd]. [WISC-III] was done to all patients. We found that the incidence of SCI was 15% among our patients with SCA and the most common clinical event predicting SCI was seizures as it occured in 2 out of 3 patients with SCI, also decreased hemoglobin concentration and increased leucocytic count were a risk factors for developing SCI. We also found that patients with SCA and SCI had significantly lower full scale intelligence quotient [IQ] than patients with normal MRI although the latter patients also have lower IQ than the normative data supplied by the test. So we concluded that all patients with SCA must undergo careful clinical, radiological and neuropsychological evaluation for early detection of SCI and congnitive impairment in these patients