Abstract
Background/aimSilent cerebral infarct (SCI) is an ischemic lesion seen before clinical signs of brain infarct and ischemic changes in brain tissue. This study aimed to detect SCI with noninvasive methods and to determine related risk factors in patients with sickle cell anemia (SCA).Materials and methodsFifty-four SCA patients who had no history of cerebral infarct and whose neurological examinations were normal were included in this study. Brain magnetic resonance imaging (MRI) and diffusion MRI were taken and the acquired data was compared statistically.ResultsSCI was detected in 11.1% (6/54) of the patients. No statistical differences in age, sex, physical examination findings, or treatments were detected between the 2 groups (with and without SCI). When examined in terms of HbS, the median (min–max) value in SCI-positive patients was 85.4 (80.5–92.1); the median value was 77.2 (49.0–96.7) in SCI-negative patients. The HbS values of the SCI group were statistically significantly higher than those of the group without SCI (P = 0.014). Patients with the HbSS or HbSβ0 genotypes had a significantly higher prevalence of SCI when compared with other sickle cell syndromes (P = 0.038).ConclusionSCI is not uncommon among SCA patients in Turkey. The presence of homozygote HbSS/Sβ0 genotype, high MCV, and HbS are risk factors for SCI.
Highlights
Sickle cell anemia (SCA) is widely distributed in Africa and the Mediterranean region [1,2]
Silent cerebral infarcts (SCI) are detected by magnetic resonance imaging procedures but do not cause abnormalities on neurological examination. These ischemic lesions seem to be related to the recurrence of an infarct; either clinical stroke or SCI are associated with transient ischemic attack (TIA), and related with mild mental retardation and future hemorrhagic stroke [4,5]
Of the 54 SCA patients undergoing follow-up and treatment at the Pediatric Hematology Department, 6 patients had SCI based on the brain magnetic resonance imaging (MRI) and diffusion MRI examinations
Summary
Sickle cell anemia (SCA) is widely distributed in Africa and the Mediterranean region [1,2]. Sickle hemoglobin (Hb) is the most common abnormal Hb in Turkey, with a frequency of 0.37%–0.60%, and an HbS heterozygosity of 3%–44% in the Çukurova region [3]. Silent cerebral infarcts (SCI) are detected by magnetic resonance imaging procedures but do not cause abnormalities on neurological examination. These ischemic lesions seem to be related to the recurrence of an infarct; either clinical stroke or SCI are associated with transient ischemic attack (TIA), and related with mild mental retardation and future hemorrhagic stroke [4,5]. Our study, conducted in southern Turkey, aimed to detect SCI by
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