Neurosurgical crisis in sickle cell disease: Case reports of haemorrhagic stroke in paediatric patients.

Dr (Prof) R.  Mishra; Dr. Katyayani  Rai; Dr. Prativa  Gari; Dr. Niraj  Kumar; Dr. Anand  Kumar

doi:10.51168/sjhrafrica.v6i12.2450

Authors

Dr. (Prof) R. Mishra Professor & HOD, Department of Pediatrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Katyayani Rai Junior resident, Department of Pediatrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Prativa Gari Junior resident, Department of Pediatrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Niraj Kumar Junior resident, Department of Pediatrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Anand Kumar Junior resident, Department of Pediatrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2450

Keywords:

Anemia, hematoma, neurological, sickling, stroke

Abstract

A collection of hemoglobinopathies known as sickle cell disease (SCD) ranges in severity; the most severe type, homozygous sickle cell anemia, is more frequently linked to neurological issues. These are ascribed to micro-obstruction and vaso-occlusion in the circulation of the central. nervous system. Across different series, the incidence of neurologic problems in SCD ranges from 6% to 30%. Silent cerebral infarction (SCI), ischemic stroke, transient ischemic episodes (TIAs), headaches, seizures, and neurocognitive impairment are among the conditions that are frequently documented in the literature.

One of the most debilitating symptoms of sickle cell disease (SCD) in children is cerebral vascular problems. Haemorrhagic stroke is a neurosurgical emergency with a high morbidity and fatality rate, whereas ischemic stroke is recorded more often. Subarachnoid hemorrhage (SAH), hemorrhagic stroke, and extradural and subdural hematomas are examples of hemorrhagic consequences that are rarely considered, particularly when there is no trauma.

This article delineates three uncommon spontaneous hemorrhagic manifestations of sickle cell anaemia: a case of subdural hematoma (SDH), a case of extradural hematoma (EDH) concomitant with SDH and subarachnoid haemorrhage, and a case of intracranial haemorrhage. These cases highlight the importance of early neuroimaging, aggressive supportive care, and multidisciplinary management in preventing adverse outcomes.

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