Document Detail


Effect of transfusion therapy on arteriographic abnormalities and on recurrence of stroke in sickle cell disease.
MedLine Citation:
PMID:  6689947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stroke is a relatively frequent and severe complication of sickle cell disease. We performed cerebral arteriograms in 30 patients with sickle cell disease to evaluate the cause of acute neurologic deficits and to assess the effects of transfusion therapy given for a year or more after the acute episode. Twenty-three patients with motor and speech deficits had multiple abnormalities of major cerebral arteries. The internal carotid and anterior and middle cerebral arteries showed stenosis and/or occlusion at their common junction. Irregular luminal surfaces suggested that endothelial damage and intimal hyperplasia were the basis of stroke. Prolonged transfusion therapy nearly stopped progression of stenosis and markedly decreased the irregularity of the luminal surfaces; in 4 untransfused patients, the degree of stenosis doubled and the luminal abnormalities persisted. Prior to transfusion, 90% of patients had recurrence of stroke. With transfusion therapy, only 10% of patients had recurrence despite persistent arterial abnormalities. Clinical recurrences per patient-month decreased 75-fold. The patients tolerated prolonged transfusion therapy well, despite progressive iron accumulation. Seven patients with smooth abnormalities of a single artery, nonocclusive changes, or with normal arteriograms did not receive transfusions. Only one of this group had recurrence of symptoms.
Authors:
M O Russell; H I Goldberg; A Hodson; H C Kim; J Halus; M Reivich; E Schwartz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Blood     Volume:  63     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  1984 Jan 
Date Detail:
Created Date:  1984-02-14     Completed Date:  1984-02-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  162-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Anemia, Sickle Cell / complications,  physiopathology,  therapy*
Arterial Occlusive Diseases / etiology,  radiography,  therapy
Blood Transfusion* / adverse effects
Brain Ischemia / etiology,  radiography,  therapy
Cerebral Angiography
Cerebral Arteries / physiopathology*
Cerebrovascular Disorders / etiology,  radiography,  therapy*
Child
Child, Preschool
Constriction, Pathologic / pathology
Humans
Infant
Recurrence
Grant Support
ID/Acronym/Agency:
AM 00570/AM/NIADDK NIH HHS; NS 10939/NS/NINDS NIH HHS; RR 00240/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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