Sickle cell and the brain

ternative diagnoses such as subdural hematoma due to trauma, brain abscess or tumor and some kinds of cen-tral nervous system (CNS) infections. Cranial magnetic resonance imaging (MRI) is usu-ally the next step to accomplish one of several objec-tives. The following techniques are useful to define im-portant pathology: • Diffusion weighted imaging (DWI)5 can produce a very sensitive map of areas of acute (less than 1 hour) ischemia and verify that the symptoms in question are indeed ischemic. In some cases it can show mul-tiple areas, not suspected clinically, that can aid in determining the cause of the stroke syndrome. • Routine T1 and T2 weighted imaging produce sensi-tive and specific brain images that show gray and white matter contrast, borderzone lesions that are especially prone to insult in SCD, cerebrospinal fluid (CSF) spaces, intracranial blood, edema and mass lesions to full advantage.6,7 • Magnetic resonance angiography (MRA) is based on the movement of blood through the arteries dur-ing each MRI pulse sequence and has been shown to correlate reasonably well in some studies with conventional angiography.8 It can detect large ves-sel disease in the internal carotid and middle cere-bral arteries at least when it is severe, and can de-tect large aneurysms and vascular malformations. Cranial Arterial Imaging The presence of an infarction is detected by parenchy-mal imaging, but the status of the vessels provides other related important information regarding the risk of fu-ture stroke. Although there is little prospective angio-Sickle cell disease affects many organ systems, but one of the major morbidities is brain disease, especially stroke. In this paper, the etiology, diagno-sis, treatment, and prevention of clinical stroke, as well as so-called “silent stroke, ” are examined. Ris