ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2022
Brain Magnetic Resonance Imaging and Angiography in Children with Sickle Cell Anaemia in Uganda in a Cross-Sectional Sample.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Incident Stroke in Pediatric Sickle Cell Anemia Despite Overall Improved Transcranial Doppler Velocity in a Ugandan Hydroxyurea Trial: Antecedent and Ongoing Risks.Pediatric blood & cancer · 2025Trial
- mHealth-Enabled Stroke Screening for Pediatric Sickle Cell Disease in Low-Resource Settings: Systematic Literature Review of Critical Barriers, Emerging Technologies, and AI-Driven Solutions.JMIR pediatrics and parenting · 2026Review
- Academic Proficiency in Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study.Pediatric blood & cancer · 2025Article
- Hydroxyurea therapy for neurological and cognitive protection in pediatric sickle cell anemia in Uganda (BRAIN SAFE II): Protocol for a single-arm open label trial.Contemporary clinical trials communications · 2024Article
- Neurocognitive Impairment in Ugandan Children with Sickle Cell Anemia Compared to Sibling Controls: A cross-sectional study.medRxiv : the preprint server for health sciences · 2024Article
- Hydroxyurea Therapy for Neurological and Cognitive Protection in Pediatric Sickle Cell Anemia in Uganda (BRAIN SAFE II): Protocol for a single-arm open label trial.medRxiv : the preprint server for health sciences · 2024Article
- Neurocognitive impairment in Ugandan children with sickle cell anemia compared to sibling controls: a cross-sectional study.Frontiers in stroke · 2024Article
- Prevention of stroke and cognitive decline in pediatric population in resource-limited settings.Frontiers in stroke · 2024Review
- Neurofilament light chain: A potential biomarker for cerebrovascular disease in children with sickle cell anaemia.British journal of haematology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveChildren with sickle cell anaemia (SCA) are highly susceptible to cerebrovascular injury. We performed brain magnetic resonance imaging and angiography (MRI-MRA) in Ugandan children with SCA to identify structural cerebrovascular abnormalities and examine their relationship to standardized clinical assessments.
methodsA sub-sample (n=81) was selected from a cross-sectional study of children attending SCA clinic, including 52 (64.2%) with and 29 (35.8%) without clinically detected abnormalities. Clinical evaluation included assessment for prior stroke, cognitive testing and cerebral arterial transcranial doppler (TCD) flow velocity. MRI-MRA scans were interpreted by at least two neuroradiologists.
resultsMean age was 6.5±2.7 years, with 39 (48.1%) female. Mean haemoglobin was 7.3±0.9 g/dl. Overall, 13 (16.0%) were malnourished. Infarcts and/or stenoses were detected in 55 (67.9%) participants, with stenoses primarily in the anterior circulation. Infarcts were seen in those with normal 17/29 (58.6%) or abnormal 34/52 (65.4%) clinical testing (p=0.181). Neither abnormal MRI nor MRA was associated with age, sex, haemoglobin, or malnutrition. Abnormal MRA was highly associated with infarcts (p<0.0001). Participants with abnormal imaging had two-fold higher proportion of stroke on exam and/or impaired cognition. Stroke on exam was strongly associated with an imaging abnormality after adjusting for age, sex, malnutrition, and haemoglobin (OR 11.8, 95%CI 1.87-74.2).
conclusionOver half of these SCA children had cerebrovascular infarcts and/or arterial stenoses. Cerebrovascular disease was frequently undetectable by clinical assessments. While rarely available in under-resourced settings, MRI-MRA brain imaging is an important tool for defining SCA cerebrovascular disease and for assessing impact of clinical intervention trials.
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