Intracranial hemorrhage in children with sickle cell disease
J. Van Hoff, A. K. Ritchey and B. A. Shaywitz
We treated two children with sickle cell disease and intracranial
hemorrhage. The incidence of intracranial hemorrhage is increased in sickle
cell disease, although not as markedly as that of cerebral infarction.
Intracranial hemorrhage has a higher mortality, a lower rate of permanent
neurologic impairment, and occurs more often in older patients than does
cerebral infarction. Intracranial hemorrhage in adults is likely to be an
intracerebral hemorrhage or a subarachnoid hemorrhage secondary to an
aneurysm. Children, however, are more likely to have subarachnoid
hemorrhage without an identifiable aneurysm. We hypothesize that both
hemorrhages and infarcts are due to large-vessel cerebral vasculopathy
secondary to the abnormal rheologic features of sickled cells.
