People with sickle cell anemia, especially children, are more likely to experience a stroke. Silent strokes, which don’t cause noticeable symptoms, are especially common.
Sickle cell anemia (SCA) is a type of sickle cell disease, a genetic condition that affects the shape and function of your red blood cells.
People with SCA have mutations in both of their hemoglobin genes. This causes them to make stiff, unusually shaped red blood cells resembling a crescent or sickle rather than flexible round discs. These cells can reduce or block your blood flow, which can cause different complications, including stroke.
Keep reading to learn more about the connection between SCA and stroke.
Can sickle cell anemia cause a stroke?
Stroke (a disruption in blood flow to the brain) is one of the most serious complications of SCA . Without preventive care, around 11% of children and 24% of adults with SCA have a stroke.
There are two main types of strokes that people with SCA may experience: ischemic stroke and hemorrhagic stroke .
An ischemic stroke occurs when sickle-shaped blood cells clog a blood vessel, blocking blood flow to the brain.
A hemorrhagic stroke, on the other hand, happens when a blood vessel in the brain bursts. This can occur due to damage in the blood vessels caused by SCA.
Sickle cell anemia and stroke statistics
- Somewhere between 5% and 17% of people with SCA have a stroke before reaching adulthood.
- In a 2023 study , the average age of children with SCA admitted to the hospital for stroke was 8.2 years.
- Children with SCA are 221 times more likely to have a stroke than children without SCA.
- The prevalence of stroke among children with SCA is less than one-sixth of what it used to be, thanks to advances in screening and treatment.
What are stroke symptoms to look for when you have sickle cell anemia?
You can use the “BE-FAST” method to quickly recognize the signs of a stroke in yourself or a loved one:
- Balance: sudden difficulty walking, dizziness, loss of balance or coordination
- Eyes: sudden trouble seeing or vision changes in one or both eyes
- Face: drooping or numbness on one side of the face
- Arm: weakness or numbness in one of the arms
- Speech: sudden difficulty in speaking or understanding speech
- Time: time to call 911 or your local emergency services, even if symptoms go away
Silent strokes and sickle cell anemia
Silent ischemic strokes, also known as silent cerebral infarcts, are the most common neurological (brain-related) complication in children and adults with SCA. Most studies report that about 20% to 50% of people with SCA experience these silent infarcts.
Silent strokes don’t cause immediate symptoms but can lead to long-term damage to your brain. The only way to detect this complication is to have a brain scan. Some specially trained doctors may be able to see signs of silent strokes before testing.
As a result of a silent stroke, you can have decreased cognitive (thinking) ability, balance issues, and other symptoms.
How do doctors treat stroke in people with sickle cell anemia?
To treat stroke in people with sickle cell anemia, doctors use both immediate medical intervention and long-term management strategies.
Immediate medical intervention
During a stroke, people with SCA need emergency blood transfusion to replace the “sickled” blood with healthy blood from a donor.
Ischemic stroke treatment for people without SCA often involves a thrombolytic drug called tissue plasmogen activator (tPA). While the National Heart, Lung, and Blood Institute recommends blood transfusions over tPA for people with SCA, research from 2017 suggests that tPA is safe for adults in this situation.
Long-term management
The two main goals of long-term management after a stroke in people with SCA are preventing future strokes and improving cognitive function.
To prevent future strokes, you will likely take hydroxyurea , a medication that changes the shape of red blood cells. You may also need lifelong blood transfusions.
To help with cognitive function, you may have follow-up appointments with a neurologist (a brain doctor). This healthcare professional will help you develop an individual plan to help boost your brain function.
What are the risk factors for stroke in sickle cell anemia?
Several factors can increase the risk of stroke in people with SCA, including:
How can I prevent stroke if I have sickle cell disease?
Some of the strategies to prevent stroke in people with SCA include:
Frequently asked questions
What happens to the brain when you have sickle cell anemia?
In people with SCA, the unhealthy red blood cells can block blood flow to the brain, leading to ischemic strokes. They can also cause blood vessels to tear, leading to hemorrhagic strokes. Both types of strokes can cause significant long-term damage to your brain.
According to a 2022 research review , other neurological symptoms in people with SCA may include headaches and cognitive dysfunction, such as challenges with attention, memory, and learning.
What is the most common cause of death in sickle cell anemia?
In a 2024 study of 123 people with sickle cell disease, sepsis and acute chest syndrome (ACS) were the most frequent complications associated with death. ACS results from sickle cells blocking the flow to the lungs.
Symptoms of ACS include:
Can sickle cell trait cause a stroke?
Sickle cell trait is a type of sickle cell disease in which a person has one healthy hemoglobin gene and one sickle hemoglobin gene.
This condition doesn’t typically cause people to have sickle cells. But in rare cases, people with sickle cell trait may develop unhealthy red blood cells in their blood, which can potentially cause a stroke. Conditions that can lead to this include:
- severe dehydration
- high altitudes
- intense physical exertion
Takeaway
SCA significantly increases the risk of stroke, a serious and potentially life threatening complication. If you have SCA, recognizing stroke symptoms, seeking timely treatment, and using preventive measures are all essential for managing this risk.
If you or your loved ones have SCA, regular medical care and a healthy lifestyle can help mitigate the dangers associated with strokes.
Most Popular
Comments / 0