Role of Transcranial Doppler in Assessment of Intracranial Blood Velocities in Children with Sickle Cell Disease: A Review of the Nigerian Experience

Abstract

Stroke  is  a  devastating  and  yet  preventable sequelae of intracranial vasculopathy in children  and  adults  with  sickle  cell  disease. Transcranial Doppler (TCD) ultrasonography is an established imaging modality for monitoring of intracranial vascular velocities and stratification of children with sickle cell disease based on the velocities into different risk groups with the aim of identifying those at high risk of stroke. Blood transfusion therapy and Hydroxyurea have been successful in the primary prevention of stroke. Transcranial Doppler screening is the standard of care in the United States and other developed countries, but  poorly  utilized  in  Nigeria  with  only  a  few centres having availability of TCD ultrasound. This  traditional  review  article  highlights  the basic intracranial vascular anatomy, TCD protocol  and  current  practices  of  intracranial vascular velocity screening and stroke prevention in Nigeria.