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Stroke in Sickle Cell Disease — RACP Paediatrics MCQ

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HardNeurology & DevelopmentStroke in Sickle Cell DiseaseRACP Paediatrics

A 7-year-old girl presents with new-onset right-sided weakness and speech difficulty. CT brain shows a left middle cerebral artery territory infarct. She has sickle cell disease (HbSS). Which investigation was most likely abnormal prior to this event and could have predicted the stroke?

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Correct answer: C — Transcranial Doppler ultrasound

Children with sickle cell disease (HbSS) have a high stroke risk. Transcranial Doppler (TCD) screening identifies children with elevated cerebral blood flow velocities (>200 cm/s in the MCA) who are at high risk of stroke. Regular TCD screening from age 2 and prophylactic chronic transfusion therapy in those with abnormal TCD significantly reduces stroke risk.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Sickle Cell Disease