TRANS CRANIAL DOPPLER (TCD) SCANNING IN CHILDREN FOR STROKE PREVENTION

Introduction: Stroke is among the top ten causes of death in childhood. the incidence of stroke is around 2 per100,000-population (approximately 30–40 cases per year in RCH Melbourne)1 majority ends up in long term neuro-disabilities.

Stroke Prevention Studies on Sickle Cell Disease (SCD) children, has helped in primary prevention of stroke in children by early identification of cerebral arterial blood flow changes using TCD Scanning. TCD scanning with treatment is cost effective 2

In Australia, SCD, although uncommon is now increasing because of the migration of genetically susceptible population. TCD scanning is used in Australian Intensive Care Units. This presentation is to share our experience to explore the use of TCD scan to prevent stroke in high risk Australian children.

Methods: All SCD children who had TCD scan during the period 2004–2009 in Royal London Hospital were analysed retrospectively.

Results: A total of 360 children between 2 and 16 yrs. old had TCD scanning; 6% had high velocities (high risk) of which 3% showed silent/+ clinical signs of infarction. Blood flow velocity of children on treatment returned to normal standard.

Conclusion: TCD is a useful investigation tool in early recognition and prevention of stroke in high risk SCD children. Use of TCD scanning can be explored in all high risk children for stroke in Australia.