How do we measure brain health?

• Transcranial Doppler: An ultrasound of the brain that measures the blood flow to the brain.


• Computerized Tomography (CT): Uses many x-rays from different angles to take detailed pictures of the brain to see if there are parts of the brain not getting enough oxygen or if there is a bleed. It is more detailed than a transcranial doppler but not as detailed as an MRI.


• Magnetic Resonance Imaging (MRI): A test that uses a magnetic field to take very detailed pictures of the brain to see if there are parts of the brain that are not getting enough oxygen or if there is a bleed.

How does sickle cell disease affect the brain?

Red blood cells that have become sickle-shaped or a blood clot can block blood flow an area of the brain causing a stroke. A stroke can also happen when there is bleeding into the brain (also referred to as hemorrhagic stroke). In both of these cases, the brain does not get the oxygen that it needs, and brain cells can die. Half of people who have one stroke will have another stroke in their lifetime. If someone thinks they are having a stroke, it is important to seek medical care right away so that pictures of the brain can be taken (CT and/or MRI). People who have a blood clot may need medicines to break up the clot. Some people may a blood transfusion (either a simple transfusion or a red cell exchange) so that the brain can get better blood flow and oxygen. A stroke or repeated strokes may be a reason that doctor may recommend curative therapy for a person who has sickle cell disease.

We hope to understand more about how curative therapy affects the brain through COALESCE by gathering information about people who have had strokes before and after curative therapy.