Details

Autor(en) / Beteiligte

• Miller, Scott T.
• Macklin, Eric A.
• Pegelow, Charles H.
• Kinney, Thomas R.
• Sleeper, Lynn A.
• Bello, Jacqueline A.
• DeWitt, L.Dana
• Gallagher, Dianne M.
• Guarini, Ludovico
• Moser, Franklin G.
• Ohene-Frempong, Kwaku
• Sanchez, Nelson
• Vichinsky, Elliott P.
• Wang, Winfred C.
• Wethers, Doris L.
• Younkin, Donald P.
• Zimmerman, Robert A.
• DeBaun, Michael R.

Titel

Silent infarction as a risk factor for overt stroke in children with sickle cell anemia: A report from the Cooperative Study of Sickle Cell Disease

Ist Teil von

• The Journal of pediatrics, 2001-09, Vol.139 (3), p.385-390

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2001

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• Objective: To determine whether children with homozygous sickle cell anemia (SCD) who have silent infarcts on magnetic resonance imaging (MRI) of the brain are at increased risk for overt stroke. Methods: We selected patients with homozygous SCD who (1) enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) before age 6 months, (2) had at least 1 study-mandated brain MRI at age 6 years or older, and (3) had no overt stroke before a first MRI. MRI results and clinical and laboratory parameters were tested as predictors of stroke. Results: Among 248 eligible patients, mean age at first MRI was 8.3 ± 1.9 years, and mean follow-up after baseline MRI was 5.2 ± 2.2 years. Five (8.1%) of 62 patients with silent infarct had strokes compared with 1 (0.5%) of 186 patients without prior silent infarct; incidence per 100 patient-years of follow-up was increased 14-fold (1.45 per 100 patient-years vs 0.11 per 100 patient-years, P = .006). Of several clinical and laboratory parameters examined, silent infarct was the strongest independent predictor of stroke (hazard ratio = 7.2, P = .027). Conclusions: Silent infarct identified at age 6 years or older is associated with increased stroke risk. (J Pediatr 2001;139:385-90)