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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3689-3694. Prepublished online as a Blood First Edition Paper on January 29, 2004; DOI 10.1182/blood-2003-08-2733. This Article Full Text (PDF) All Versions of this Article: 2003-08-2733v1 103/10/3689    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Adams, R. J Articles by Roach, E S Search for Related Content PubMed PubMed Citation Articles by Adams, R. J Articles by Roach, E S Social Bookmarking                   What's this? Submitted August 19, 2003 Accepted January 16, 2004 Stroke and Conversion to High Risk in Children Screened with Transcranial Doppler Ultrasound during the STOP Study Robert J Adams*, Donald J Brambilla, Suzanne Granger, Dianne Gallagher, Elliott Vichinsky, Miguel Abboud, Charles H Pegelow, Gerald Woods, Elizabeth Rohde, Fenwick T Nichols, Anne Jones, Judith P Luden, Latonya Bowman, Susan S Hagner, Knashawn H Morales, and E S Roach Neurology, Medical College of Georgia, Augusta, GA, USA New England Research Institutes, Watertown, MA, USA Hematology/Oncology, Children's Hospital of Oakland, Oakland, CA, USA Hematology/Oncology, Medical University of South Carolina, Charleston, SC, USA Sickle Cell, University of Miami School of Medicine, Miami, FL, USA Hematology/Oncology, Children's Mercy Hospital, Kansas City, MO, USA Neurology, Wake Forest University School of Medicine, Winston Salem, NC, USA * Corresponding author; email: rjadams{at}mail.mcg.edu. The Stroke Prevention Trial in Sickle Cell Anemia (STOP) was a randomized multi-center controlled trial comparing prophylactic blood transfusion to standard care in SCD children aged 2 to 16 years selected for high stroke risk by TCD. Over two thousand children were screened with TCD to identify the 130 high-risk children who entered the randomized trial. A total of 5,613 TCD studies from 2,324 children were evaluated. We also collected information on stroke. We describe the changes in TCD with repeat testing and report the outcome without transfusion in the STOP screened cohort. Risk of stroke was higher with abnormal TCD than with normal or conditional TCD (p<.001) or inadequate TCD (p=.002), and risk with conditional TCD was higher than with normal TCD (p<.001). Repeat TCD in 1215 children showed that 9.4% of children became abnormal during observation. Younger patients and those with higher initial flow velocities were most likely to convert to abnormal. Screening in STOP confirmed the predictive value of TCD for stroke. Substantial differences in probability of conversion to abnormal TCD were observed, with younger children and those with higher velocity more likely to have an abnormal TCD with re-screening. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. Schatz, C. B. McClellan, E. S. Puffer, K. Johnson, and C. W. Roberts Neurodevelopmental Screening in Toddlers and Early Preschoolers With Sickle Cell Disease J Child Neurol, January 1, 2008; 23(1): 44 - 50. [Abstract] [PDF] M. Mazumdar, M. M. Heeney, C. M. Sox, and T. A. Lieu Preventing Stroke Among Children With Sickle Cell Anemia: An Analysis of Strategies That Involve Transcranial Doppler Testing and Chronic Transfusion Pediatrics, October 1, 2007; 120(4): e1107 - e1116. [Abstract] [Full Text] [PDF] J. Krejza, W. Rudzinski, M.A. Pawlak, M. Tomaszewski, R. Ichord, J. Kwiatkowski, D. Gor, and E.R. Melhem Angle-Corrected Imaging Transcranial Doppler Sonography versus Imaging and Nonimaging Transcranial Doppler Sonography in Children with Sickle Cell Disease AJNR Am. J. Neuroradiol., September 1, 2007; 28(8): 1613 - 1618. [Abstract] [Full Text] [PDF] S. A. Zimmerman, W. H. Schultz, S. Burgett, N. A. Mortier, and R. E. Ware Hydroxyurea therapy lowers transcranial Doppler flow velocities in children with sickle cell anemia Blood, August 1, 2007; 110(3): 1043 - 1047. [Abstract] [Full Text] [PDF] J. J. Strouse, M. L. Hulbert, M. R. DeBaun, L. C. Jordan, and J. F. Casella Subarachnoid Hemorrhage in a Young Child With Sickle Cell Disease: Is Transcranial Doppler Helpful?: In Reply Pediatrics, June 1, 2007; 119(6): 1250 - 1251. [Full Text] [PDF] S. Austin, H. Cohen, and N. Losseff Haematology and neurology J. Neurol. Neurosurg. Psychiatry, April 1, 2007; 78(4): 334 - 341. [Abstract] [Full Text] [PDF] M. R. DeBaun and J. J. Field Limitations of Clinical Trials in Sickle Cell Disease: A Case Study of the Multi-center Study of Hydroxyurea (MSH) Trial and the Stroke Prevention (STOP) Trial Hematology, January 1, 2007; 2007(1): 482 - 488. [Abstract] [Full Text] [PDF] N. Valadi, G. S. Silva, L. S. Bowman, D. Ramsingh, P. Vicari, A. C. Filho, A. R. Massaro, A. Kutlar, F. T. Nichols, and R. J. Adams Transcranial Doppler ultrasonography in adults with sickle cell disease. Neurology, August 22, 2006; 67(4): 572 - 574. [Abstract] [Full Text] [PDF] M. T. Lee, S. Piomelli, S. Granger, S. T. Miller, S. Harkness, D. J. Brambilla, R. J. Adams, and for the STOP Study Investigators Stroke Prevention Trial in Sickle Cell Anemia (STOP): extended follow-up and final results Blood, August 1, 2006; 108(3): 847 - 852. [Abstract] [Full Text] [PDF] L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Circulation, June 20, 2006; 113(24): e873 - e923. [Abstract] [Full Text] [PDF] L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke, June 1, 2006; 37(6): 1583 - 1633. [Abstract] [Full Text] [PDF] O. S. Platt Prevention and Management of Stroke in Sickle Cell Anemia Hematology, January 1, 2006; 2006(1): 54 - 57. [Abstract] [Full Text] [PDF] Col. K. C. Quirolo Resources aid in management of sickle cell disease AAP News, October 1, 2004; 25(4): 190 - 191. [Full Text] [PDF]

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