Subarachnoid hemorrhage in sickle-cell disease.

The neurological complications of sickle-cell disease include cerebral intracerebral hemorrhage; subarachnoid hemorrhage (SAH) has been infrequently reported. Among 325 patients with sickle-cell disease followed at the University of Illinois between 1975 and 1989, 11 cases of SAH were identified. Aneurysms were found in 10 of these patients, three of whom had multiple aneurysms. All of the patients had some degree of anemia and nine underwent craniotomy without hematological or neurological complications. From this review it appears that SAH is not uncommon in sickle-cell disease patients and tends to occur at a younger age and with smaller aneurysm size than in the general population. With proper perioperative management, including exchange transfusions to reduce the proportion of hemoglobin S to less than 30%, these patients can undergo angiography and craniotomy without an increased incidence of complications. The techniques used in managing sickle-cell disease patients with SAH are discussed.

[1]  T J Masaryk,et al.  Magnetic resonance angiography of the extracranial carotid arteries and intracranial vessels , 1989, Neurology.

[2]  M. McDermott,et al.  Temporary vessel occlusion and barbiturate protection in cerebral aneurysm surgery. , 1989, Neurosurgery.

[3]  W. Stehbens,et al.  Etiology of intracranial berry aneurysms. , 1989, Journal of neurosurgery.

[4]  D. Esseltine,et al.  Sickle cell states and the anaesthetist , 1988, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[5]  J. Rice,et al.  Assessment of the Use of Transfusion Therapy Perioperatively in Patients with Sickle Cell Hemoglobinopathies , 1988, Annals of surgery.

[6]  R. Leblanc,et al.  Familial intracranial aneurysms. , 1987, Journal of neurosurgery.

[7]  E. Evans,et al.  Characterization of cellular determinants and plasma factors responsible for increased adherence of sickle cells to vascular endothelium. , 1987, Progress in clinical and biological research.

[8]  P. L. la Celle,et al.  Erythrocyte-endothelial cell adherence in sickle cell disorders. , 1986, Blood.

[9]  B. Shaywitz,et al.  Intracranial hemorrhage in children with sickle cell disease. , 1985, American journal of diseases of children.

[10]  G. Sypert,et al.  Ruptured intracranial aneurysms in cases of sickle cell anemia. , 1985, Neurosurgery.

[11]  A. Rothman,et al.  Multiple intracranial aneurysms in sickle cell anemia. Report of two cases. , 1985, Journal of neurosurgery.

[12]  J. Caprioli,et al.  Acute monocular visual loss secondary to anterior communicating artery aneurysm in a patient with sickle cell disease. , 1983, Annals of ophthalmology.

[13]  E. Hitchcock,et al.  Subarachnoid hemorrhage in sickle-cell anemia. , 1983, Surgical neurology.

[14]  M. Pratila,et al.  Anesthetic management of cerebral aneurysmectomy in a sickle cell anemia patient. , 1982, The Mount Sinai journal of medicine, New York.

[15]  J. Lusher,et al.  Neurological complications of sickle cell anemia. , 1982, The American journal of pediatric hematology/oncology.

[16]  P. Kishore,et al.  Major intracerebral arterial involvement in sickle cell disease. , 1980, Surgical neurology.

[17]  J. Eaton,et al.  Erythrocyte adherence to endothelium in sickle-cell anemia. A possible determinant of disease severity. , 1980, The New England journal of medicine.

[18]  J. Homi.  General anaesthesia in sickle-cell disease. , 1979, British medical journal.

[19]  C. Pegelow,et al.  The natural history of stroke in sickle cell disease. , 1978, The American journal of medicine.

[20]  D. H. Wood.  Cerebrovascular Complications of Sickle Cell Anemia , 1978, Stroke.

[21]  W. Buchheit,et al.  The management of ruptured intracranial aneurysm in sickle cell anemia. Case report. , 1977, Journal of neurosurgery.

[22]  M. Reivich,et al.  Transfusion therapy for cerebrovascular abnormalities in sickle cell disease. , 1976, The Journal of pediatrics.

[23]  J. Stockman,et al.  Occlusion of large cerebral vessels in sickle-cell anemia. , 1972, The New England journal of medicine.

[24]  J. Herion,et al.  Neurological manifestations in sickle-cell disease, with a review of the literature and emphasis on the prevalence of hemiplegia. , 1972, Annals of internal medicine.

[25]  A. Adeloye,et al.  Massive intracranial hemorrhage in sickle cell anemia , 1970, Neurology.

[26]  W. Hunt,et al.  Surgical risk as related to time of intervention in the repair of intracranial aneurysms. , 1968, Journal of neurosurgery.

[27]  H. Locksley,et al.  Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. , 1966, Journal of neurosurgery.

[28]  H. Locksley.  SECTION V, PART I: Natural History of Subarachnoid Hemorrhage, Intracranial Aneurysms and Arteriovenous Malformations* , 1966 .

[29]  M. Cheatham,et al.  Problems in management of subarachnoid hemorrhage in sickle cell anemia. , 1965, Journal of neurosurgery.

[30]  M. Greer,et al.  Abnormal hemoglobin as a cause of neurologic disease , 1962, Neurology.

[31]  H. Ballard,et al.  Spontaneous Subarachnoid Hemorrhage in Sickle Cell Anemia , 1957, Neurology.

[32]  R. Adams,et al.  Clinical Pathologic Conference , 1953, Neurology.

[33]  H. Bloch,et al.  Sickle-cell disease , 1951 .

[34]  A. Hansen,et al.  Aureomycin in staphylococcic meningitis complicating subarachnoid hemorrhage in sickle cell anemia. , 1949, Pediatrics.

[35]  N. Mitchell,et al.  THE BRAIN IN SICKLE CELL ANEMIA , 1942 .

[36]  W. Bridgers.  Cerebral vascular disease accompanying sickle cell anemia. , 1939, The American journal of pathology.

[37]  J. Arena.  VASCULAR ACCIDENT AND HEMIPLEGIA IN A PATIENT WITH SICKLE CELL ANEMIA , 1935 .