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Strouse JJ et al. – The results suggest that the rate of stroke in SCD peaks in older adults and is three–fold higher than rates previously reported in African–Americans of similar age (35–64 years) without SCD. Stroke in SCD is associated with several known adult risk factors for ischemic and hemorrhagic stroke. Studies for the primary and secondary prevention of stroke in adults with SCD are urgently needed.

Exclusive Author Commentary
John J. Strouse, 07/24/09

Stroke and silent infarcts are recognized as one of the most morbid complications of sickle cell disease in children. Transfusion is an effective therapy for the primary and secondary prevention of stroke in this group, but has not been studied in adults because strokes were perceived to be less common. This study and a recent study demonstrating neurocognitive impairment in adults with sickle cell disease and no prior stroke (Vinchinsky et al. American Society of Hematology Meetinng Dec 2008) , support the importance of evaluating adults with sickle cell disease for stroke and cognitive impairment.

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