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Journal Article Review Epublish 5 citations

PubMed: 38107212 DOI: 10.7759/cureus.50577

Overview of the Association Between the Pathophysiology, Types, and Management of Sickle Cell Disease and Stroke.

Cureus 15(12):e50577

Authors: Faisal Hakami, Essam Alhazmi, Wafa M Busayli, Sultan Althurwi, Abdulrahman M Darraj, Mohammed A Alamir, Alyaj Hakami, Renad A Othman, Amal I Moafa, Hassan A Mahasi, Mohammed Ali Madkhali

Affiliations

  • Medicine, Faculty of Medicine, Jazan University, Jazan, SAU.
  • Medicine, Faculty of Medicine, Jazan University, Jizan, SAU.
  • Internal Medicine, and Hematology and Oncology, Faculty of Medicine, Jazan University, Jazan, SAU.

Abstract

Sickle cell disease (SCD) is a genetic blood disorder that affects hemoglobin and increases stroke risk, particularly in childhood. This review examines the pathophysiological association between SCD and stroke, the classification of stroke types, risk factors, diagnosis, management, prevention, and prognosis. A comprehensive literature search was conducted via PubMed, Scopus, and Cochrane databases. Relevant studies on SCD and stroke pathophysiology, classification, epidemiology, diagnosis, treatment, and prevention were identified. Sickle cell disease causes red blood cells to become rigid and sickle-shaped, obstructing blood vessels. Recurrent sickling alters cerebral blood flow and damages vessel walls, often leading to ischemic or hemorrhagic strokes (HS). These occur most frequently in childhood, with ischemic strokes (IS) being more common. Key risk factors include a prior transient ischemic attack (TIA), low hemoglobin, and a high leukocyte count. Neuroimaging is essential for diagnosis and determining stroke type. Primary prevention centers on blood transfusions and hydroxyurea for those at high risk. Acute treatment involves promptly restoring blood flow and managing complications. However, significant knowledge gaps remain regarding stroke mechanisms, optimizing screening protocols, and improving long-term outcomes. This review synthesizes current evidence on SCD and stroke to highlight opportunities for further research and standardizing care protocols across institutions. Ultimately, a holistic perspective is critical for mitigating the high risk of debilitating strokes in this vulnerable patient population.

MeSH

Stroke, Hemoglobinopathies, Anemia, Sickle Cell, Diagnosis, Risk Factors, Cells, Classification, Blood, Hemoglobins, Hemoglobin, Sickle

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