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Stroke in Sickle Cell Anemia: Alternative Etiologies
Pediatric Neurology , 08/06/09
Dowling MM et al. – An 11–year–old girl with sickle cell anemia presented with severe headache and was found to have recurrent bilateral multifocal strokes in a cardioembolic pattern. Evaluation revealed the presence of a patent foramen ovale, antiphospholipid antibodies, and elevations in factor VIII and lipoprotein(a). Sickle cell anemia is itself a hypercoagulable state with potential for increased right heart pressures, both of which predispose to paradoxical embolization via right–to–left intracardiac shunting of emboli, thus causing stroke.
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