The risk of stroke is highest in children with sickle cell anaemia who have abnormally narrowed cerebral vessels. Narrowing of the large intracranial vessels results in increased velocity of blood flow.
In a study, blood flows in excess of 170 cm/sec were defined as abnormal. The relative risk of stroke in patients with abnormal intracranial doppler studies was 44 (95% confidence interval, 5.5 to 346).
The authors suggested that blood transfusion policy should be more aggressive in these high-risk patients.
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