Cerebrovascular events are very common in sickle cell disease (SCD), and multiple mechanisms are probably involved in their pathophysiology. We report a 30-year-old woman who presented a large volume silent stroke followed 2 months later by a second large volume stroke that manifested only with transient arm weakness. In the acute phase, magnetic resonance angiography revealed a segmental stenosis of the 2 different large intracranial vessels supplying the stroke territories. Partial regression of vascular stenosis was revealed by a follow-up magnetic resonance imaging. Present case suggests that stenosis of large intracranial vessels, possibly related to vascular injury promoted by the endothelial adhesion of reticulocytes and inflammatory elements, is involved in large volume brain infarcts in SCD.
Keywords: Sickle cell disease; intracranial artery stenosis; silent cerebral infarct; stroke.
Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.