AHA Logo About one-quarter to one-third of children suffering from sickle cell disease probably experience silent strokes in their brains. A recent study suggests that such silent strokes in severely anemic children have no immediate symptoms, but can lead to long-term cognitive and learning deficits. Kids with or without sickle cell disease having acute anemia can possibly go through undetected brain damage. It was suggested that those with severe anemia can be subjected to careful examination for silent strokes.

Silent strokes that occur during severe anemia are probably detectable by MRI. Hence, scientists employed MRI for scrutinizing the brains of 52 hospitalized children 2 to 19 years old with hemoglobin concentrations below 5.5 g/dL. Severely anemic children with sickle cell disease were compared to a group of children without sickle cell disease having hemoglobin levels below 5.5 g/dL. Silent strokes were registered in around 20 percent kids with sickle cell disease who were experiencing acute anemia. Evidence of silent strokes did not appear common among severely anemic kids than those who didn’t have sickle cell disease.

“These are brain injuries that go unnoticed by doctors, unless the children have testing with a special MRI,” Michael M. Dowling, M.D., Ph.D., lead author of the study and assistant professor of pediatrics and neurology at the University of Texas Southwestern Medical Center in Dallas commented. “We looked at every child who went to the hospital for a 30-month period and identified about 400 children that came in with hemoglobin below 5.5 g/dL. That represented about 12 percent of the admissions for sickle cell disease and about 1 percent of the total admissions to Children’s Medical Center.”

Kids diagnosed with sickle cell disease are at a higher risk of anemia apparently because of trauma, surgery, iron deficiency or cancer like leukemia. It was observed that children with or without sickle cell disease reporting acute anemia can be facing undetected brain damage. Those with severe anemia can be seemingly subjected to careful examination for silent strokes. Better recognition and timely transfusion to raise blood hemoglobin levels can supposedly aid in avoiding permanent brain damage.

The study was presented at the American Stroke Association’s International Stroke Conference 2011.