Evaluation of transcranial Doppler abnormalities in children with sickle cell disease in El-Obeid Specialized Children's Hospital.

Abstract

This study aims to evaluate transcranial Doppler abnormalities in children with sickle cell disease (SCD) in a specialized children's hospital in El-Obeid. This is a cross-sectional study done on 119 patients (2-18 years of age were included) who attended the sickle cell clinic in a specialized children's hospital in El-Obeid from December 2016 to February 2017; when patients do not have recent stroke symptoms, blood flow velocities were measured in both proximal internal carotid and middle cerebral arteries (MCAs) using non-imaging Doppler method, and time average mean velocities were recorded along with hemoglobin concentration and of the patients. None of the study population had MCA velocity higher than 200 cm/s; also no high conditional velocity (170-199 cm/s) was recorded, so no patient was at high risk to develop stroke. About 20.1% of patients showed low velocities in one or both MCAs; 4.2% had abnormal MCAs' interhemispheric ratio; 4.2% of study population showed absent flow in one of their MCAs, reflecting previous occlusion. About 4.2% had poor temporal window. It was difficult to measure the velocity in one of the four vessels in 5.9% of the patient due to uncooperativeness. There was statistically significant relationship between hemoglobin concentration and blood velocity in the left MCA. Despite the international recommendations, using transcranial Doppler ultrasonography (TCD) as a stroke screening tool in children with SCD in Sudan is still not a well-known practice. Successful strategies to improve TCD screening rates must be encouraged in all healthcare institutions.