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Overt strokes and silent cerebral infarcts in children with sickle cell disease (SCD) result in considerable physical and cognitive disability. Chronic transfusion therapy (TT) reduces the risk for recurrent overt strokes, but whether it also lowers the frequency of silent brain infarcts is unclear.
To investigate this issue, a consortium of researchers from seven academic SCD centers conducted prospective magnetic resonance imaging (MRI) studies of the brain in 40 children who were receiving TT for recurrent stroke prevention; median age at first stroke was 5.4 years (range, 1.0–9.4 years). Transfusions were given, on average, approximately every 28 days (range, 16.5–37.1 days) and resulted in a mean pretransfusion hemoglobin S (HbS) level …