STROKE

 
 
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What is a stroke?

People with sickle cell disease are more likely to have a stroke than someone without sickle cell disease.

A stroke is caused when blood flow to an area of the brain is blocked. Blood ow can be blocked by a blood clot or by red blood cells that have become sickle-shaped.

A stroke can also happen when there is bleeding into the brain (also referred to as hemorrhagic stroke). In either case, part of the brain does not get enough oxygen and is injured.

 

Symptoms:

The American Heart Association and the American Stroke Association have created an easy way to remember the signs of a stroke using the word “FAST.”

 
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(F) Face drooping

  • One side of your face droops or is numb.

  • Your smile is uneven or lopsided.

 
 
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(A) Arm weakness

  • One of your arms becomes weak or numb.

  • If you raise both of your arms, one may drift back down on its own.

 
 
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(S) Speech difficulty

  • Your speech becomes slurred.

  • You may not be able to talk, or your speech may be hard to understand.

  • You may not be able to repeat what is said to you.

 
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(T) Time to call 9-1-1

  • If you show any of these signs, even if they go away, call 9-1-1

  • Say, “I think this is a stroke” to get help immediately

  • Time is important! Do not wait! Be sure to notice what time the first symptoms started. Emergency responders will want to know.

 
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Other signs of a stroke include these sudden symptoms:

  • Confusion

  • Weakness on one side of your body

  • Trouble walking, loss of balance or coordination

  • Severe headache or dizziness.

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A picture of the brain will be needed right away to see if a stroke has occurred. It can also show if the stroke was caused by bleeding or by a blocked blood vessel.

Treatment

  • For most adults, a stroke may get treated with tissue plasminogen activator (tPA) through a vein.

  • For children and adults with sickle cell disease an immediate red cell exchange transfusion an immediate red cell exchange blood transfusion (apheresis) may be needed.

The goals of transfusion are to:

  1. Increase the total blood count (Hemoglobin)

  2. Lower the Hemoglobin S.


    About half of people who have one stroke may have a second stroke. With regular blood transfusions, the risk of having more strokes gets lower but does not completely go away.

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Stroke checklist

For you and your health care provider

If you have symptoms of a stroke:

🄯 Talk with your provider about getting a picture of the brain, either by CT (computerized tomography) scan or MRI (magnetic resonance imaging) to see if a stroke has occurred.

🄯 If you had a new stroke, talk with your provider about getting an immediate red cell exchange blood transfusion (apheresis). If the hospital cannot do this procedure, you may need to be transferred to another hospital that can.

Blood transfusions:

🄯 If you have had a stroke, talk with your provider about getting blood transfusions on a regular basis.

Hydroxyurea:

🄯 If you are not able to get blood transfusions on a regular basis, talk with your provider about taking hydroxyurea.

Blood clots:

🄯 Talk with your provider to see if getting a clot busting drug (thrombolytic) is right for you.

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SECTION OVERVIEW

  • If you have symptoms of a stroke (F.A.S.T.), call 911 immediately.

  • Red cell exchange blood transfusion is the first line of treatment for a new stroke for people with sickle cell disease.

  • Getting blood transfusions on a regular basis can lower your risk of having future strokes.