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This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Pegelow, C. H. Articles by Kinney, T. R. Search for Related Content PubMed PubMed Citation Articles by Pegelow, C. H. Articles by Kinney, T. R. Related Collections Red Cells Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 April 2002, Vol. 99, No. 8, pp. 3014-3018 RED CELLS Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease Charles H. Pegelow, Eric A. Macklin, Franklin G. Moser, Winfred C. Wang, Jacqueline A. Bello, Scott T. Miller, Elliott P. Vichinsky, Michael R. DeBaun, Ludovico Guarini, Robert A. Zimmerman, Donald P. Younkin, Dianne M. Gallagher, and Thomas R. Kinney From the Department of Pediatrics, University of Miami, Miami, FL; New England Research Institutes, Watertown, MA; Cedars-Sinai Medical Center, Los Angeles, CA; St Jude Children's Research Hospital, Memphis, TN; Montefiore Medical Center, Bronx, NY; State University of New York-Downstate Medical Center/King County Hospital Center, and Interfaith Medical Center, Brooklyn, NY; Children's Medical Center of Northern California, Oakland, CA; Washington University School of Medicine, St Louis, MO; Children's Hospital of Philadelphia, PA; and Duke University School of Medicine, Durham, NC. Children with sickle cell anemia (HbSS) are at high risk for neurologically overt cerebral infarcts associated with stroke and neurologically silent cerebral infarcts correlated with neuropsychometric deficit. We used complete magnetic resonance imaging (MRI) histories from 266 HbSS children, aged 6 through 19 years, who were enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) to examine silent infarct prevalence, localization, recurrence, and progression. We report a baseline prevalence of 21.8%, marginally higher than previously reported due to improved imaging technologies. Although we observed no overall sex difference in prevalence, most lesions in girls occurred before age 6, whereas boys remained at risk until age 10. Silent infarcts were significantly smaller and less likely to be found in the frontal or parietal cortex than were infarcts associated with stroke. Children with silent infarct had an increased incidence of new stroke (1.03/100 patient-years) and new or more extensive silent infarct (7.06/100 patient-years) relative to stroke incidence among all children in our cohort (0.54/100 patient-years). Both events were substantially less frequent than the risk of stroke recurrence among children not provided chronic transfusion therapy. Although chronic transfusion is known to decrease occurrence of new silent infarcts and strokes in children with elevated cerebral arterial blood flow velocity, further study is required to determine its risk-benefit ratio in children with silent infarct and normal velocities. Until safe and effective preventive strategies against infarct recurrence are discovered, MRI studies are best reserved for children with neurologic symptoms, neuropsychometric deficits, or elevated cerebral artery velocities. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. R. Kirk, M. R. Haynes, S. Palasis, C. Brown, T. G. Burns, M. McCormick, and R. A. 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	Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020