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Two hundred eighty-three transcranial ultrasound examinations were performed in 190 patients with sickle cell disease(age at entry,3 to 18 years)After an average follow-up of 29 months,cerebral infarction was diagnosed in seven patients.In 23 patients the results of the ultrasound examinations were abnormal,and in 167 patients they were normal.The clinical and hematologic characteristics of the two groups were similar, but six of the seven strokes occurred among the 23 patients with abnormal ultrasound results(P<0.00001 by Fisher's exact test).In this group,the relative risk of stroke was 44(95 percent confidence interval,5.5 to 346). Transcranial ultrasonography can identify the children with sickle cell disease who are at highest risk for cerebral infarction.Periodic ultrasound examinations and the selective use of transfusion therapy could make the primary prevention of stroke an achievable goal. |
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blood transfusion
carotid artery disease
carotid artery disease,noninvasive evaluation of
carotid artery stenosis
carotid artery stenosis,intracranial
cerebrovascular accident
cerebrovascular accident,prevention of
cerebrovascular disease,risk factors in
doppler
doppler,transcranial
sickle cell disease
treatment of neurologic disorder
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