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Abstract #3610

Hemodynamic etiology of stroke risk in children with sickle cell anemia

Przemyslaw Kosinski 1 , Paula Croal 2 , Jackie Leung 2 , and Andrea Kassner 2,3

1 Institute of Medical Science, The University of Toronto, Toronto, Ontario, Canada, 2 Physiology & Experimental Medicine, The Hospital for Sick Children, Ontario, Canada, 3 Medical Imaging, The University of Toronto, Toronto, Ontario, Canada

The stroke etiology in children with sickle cell anemia (SCA) is thought to be a result large-vessel stenosis. However, 32% of post-stroke children present without a history of stenosis. An alternative etiology is the hemodynamic insufficiency model which proposes that severe anemia exhausts vasodilatory capacity thus increasing the susceptibility for ischemic injury. We measured cerebrovascular reactivity (CVR) using BOLD MRI in synchrony with a hypercapnic stimulus to quantify vasodilatory capacity. Our results show that CVR is significantly associated with the degree of anemia (Hematocrit) in the gray matter (r=0.84,p<0.001) and white matter (r=0.81,p<0.001). These results favour the hemodynamic insufficiency model.

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