Affiliations: Department of Pediatrics, College of Medicine,
University of Ibadan/University College Hospital, Ibadan, Nigeria
Note: [] Correspondence: Dr. Ikeoluwa A. Lagunju, Department of
Pediatrics, University College Hospital/ College of Medicine, University of
Ibadan, Ibadan, Nigeria. Tel.: +234 803 5857326; E-mail: ilagunju@yahoo.co.uk
Abstract: Stroke is a devastating and potentially fatal complication of sickle
cell disease (SCD). Children who survive a stroke attack are also at increased
risk of motor disabilities, learning difficulties and epilepsy. The study was
carried out to evaluate the prevalence and characteristics of stroke and its
attendant complications in children with SCD seen at the University College
Hospital, Ibadan, Nigeria. All consecutive cases of SCD that developed a stroke
over a 4-year period were studied and followed up for a period of 1 year.
Twenty-four of 351 children with SCD developed a stroke, giving a prevalence
rate of 6.8%. The mean age at first stroke was 81.4 ±
37.2 months, 75% of children suffered the first stroke between the ages of 2
and 9 years. Ischemic stroke was the predominant form seen. The case fatality
was 4.2%. Six (26.1%) of the 23 children who survived the first stroke
had another attack of stroke within 1 year of the first stroke. The major
long-term neurological sequelae were motor disabilities, dysphasia, learning
disability and epilepsy. Stroke is a common neurological complication of SCD.
Its prevalence in Nigerian children with SCD is not lower than what is reported
in North America. The risk of recurrence after a first stroke remains high in
the absence of preventive treatment. There is a need to explore other
preventive measures apart from periodic blood transfusion to ameliorate the
burden of stroke associated with SCD in a resource-poor country like Nigeria.
