Therapy Insight: Stroke Risk and Its Management in Patients With Sickle Cell Disease

Fenella J. Kirkham


Nat Clin Pract Neurol. 2007;3(5):264-278. 

In This Article

Brain Pathology in Patients With Sickle Cell Disease

In parallel with the wide range of clinical neurological presentations of CVA in patients with SCD, a number of apparently discrepant findings have been described in the pathological literature. In patients who have presented with acute stroke, large infarcts in an arterial territory or in the border zones between anterior and middle cerebral arteries have been described,[40,41] in association with endothelial hyperplasia, fibroblastic reaction, hyalinization and fragmentation of the internal elastic lamina, and thrombi in large and small vessels.[41] Not all patients who die after developing neurological symptoms have large-vessel disease, however.[18] In addition to the typical small necrotic lesions in the border between the cortex and the subcortical white matter, acute demyelination[18] and venous sinus thrombosis[42,43] have also been documented.


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