Both ischemic and
hemorrhagic strokes in children can be a complication of
sickle cell disease, which also affects adults. The occurrence is high without any screening or preventative care. This review article found that although transcranial Doppler (TCD) has reduced the prevalence of
stroke in pediatric patients, there is still a need for an epidemiological survey to define such screening for adults, the ideal dose of
hydroxyurea to reduce the incidence of
stroke, and to identify silent
cerebral stroke to prevent its complications. Increased
hydroxyurea prescription and specific
antibiotic and vaccination regimes lowered the occurrence of this condition. In pediatric cases with a time-averaged mean of the maximal velocity greater than 200cm/s, transcranial Doppler screening and preventive chronic transfusion for at least the first year have lowered the occurrence of
stroke by up to 10 times. The ideal dose of
hydroxyurea is still debatable, but it seems to reduce the risk of the first
stroke to a comparable level in the average population. Adult ischemic and
hemorrhagic stroke prevention has not yet received the same attention. Though there are fewer studies,
sickle cell disease is also more common than age-matched controls in terms of silent cerebral infarction on magnetic resonance imaging (MRI), as well as other neurological problems such as
cognitive impairment,
seizures, and
headaches. Currently, there is no evidence-supported way to prevent
ischemic stroke in adults at any age. Also, there is no defined ideal dose of
hydroxyurea that can be helpful in preventing
strokes. Data also lack a way to identify a silent
cerebral infarction, so its complications can be prevented. An additional epidemiological survey may help in the prevention of the condition. The primary aim of this article was to emphasize the importance of information on clinical, neuropsychological, and quantitative MRI assessment of sickle cell patients to understand the epidemiology and etiology of
stroke in sickle cell patients to prevent
stroke and its related morbidity.