Two important ways to reduce stroke risk are to get recommended screening and take treatments as prescribed by your doctor. The sooner you identify stroke risk, the earlier you can take steps to lower it.

Get Stroke Screening Tests

Screening tests can help identify children with SCD who may be at risk for stroke.

MRI Screening

All children with sickle cell anemia should have an MRI of the brain when they’re old enough to stay still during the test without sedation. An MRI can help doctors look for signs of brain injury, including silent strokes.

TCD Ultrasound Screening

Children ages 2 to 16 with sickle cell anemia should have transcranial Doppler (TCD) ultrasound screening at least once a year. This painless test uses sound waves to measure how fast blood flows through the brain’s blood vessels. Abnormal results can signal a higher risk of stroke.

Despite recommendations for TCD screening, many children who qualify don’t receive it. Ask your child’s doctor when TCD screening should begin, how often it should be done, and what the results mean.

If testing shows that your child has a higher risk of stroke, their care team may recommend treatments such as regular blood transfusions to help lower that risk.

Your child’s care team can also help you find screening services and answer questions about what to expect and insurance coverage.

Take Prescribed SCD Treatments To Prevent Complications

Regular medical care is an important part of managing SCD and preventing complications such as stroke. Keeping up with appointments and treatment can sometimes be difficult, whether because of cost, transportation, work, or other barriers. If something is making it hard to get the care you or your child needs, your care team may be able to help connect you with support.

Taking prescription medications such as hydroxyurea can also help lower the risk of complications. Hydroxyurea helps red blood cells stay rounder and more flexible, making them less likely to get stuck in or damage blood vessels.

Blood Transfusions During and After a Stroke

For some people with SCD, going to the emergency room (ER) can be stressful, especially if they’ve had past experiences of having their symptoms or pain dismissed. Those experiences may make it harder to want to return to the ER.

But when stroke symptoms appear, getting evaluated and treated as quickly as possible can improve the chances of recovery and reduce the risk of lasting damage. Because time matters with a stroke, it’s important to call 911 or seek emergency care right away, even if past ER experiences have been difficult.

Everyone with SCD who has signs of an acute stroke should receive a prompt blood transfusion as part of emergency care. When possible, exchange transfusion is preferred to simple transfusion. During an exchange transfusion, some of the person’s blood is removed and replaced with donor red blood cells, quickly lowering the proportion of sickled cells.

Treatment after a stroke involves ongoing medical care, including a plan to reduce the risk of another stroke. Your care team, hospital social worker, or other support staff may be able to help with insurance questions, treatment costs, transportation, or other challenges.

Help Prevent Sickle Cell Crises

A sickle cell crisis can happen when sickled cells block blood flow in small blood vessels. A crisis can lead to serious complications such as stroke.

You can take steps to lower the chance of a crisis, including:

• Avoiding extremely hot or cold temperatures
• Avoiding or managing stressful situations when possible
• Drinking plenty of water to stay hydrated
• Getting medical care promptly for a fever, which may be a sign of infection

If a crisis starts, follow your care plan and contact your care team if you’re not sure what to do.