SILENT CEREBRAL INFARCT MULTI-CENTER TRIAL

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。镰状细胞性贫血的发病率和死亡率的主要原因是血管闭塞。镰状细胞性贫血患儿的脑梗死可能损害运动和/或认知功能。镰状细胞性贫血患者发生的显性卒中的特征是突然和持续的运动缺陷发作，导致明确的识别和及时的治疗。然而，无症状性脑梗死是镰状细胞性贫血儿童中最常见的神经损伤形式，定义为脑部MRI图像异常，多个T2加权图像信号强度增加，并且没有持续超过24小时的局灶性神经功能缺损病史或体格检查结果。唯一被证实的预防患有镰状细胞性贫血的儿童中风的治疗方法是输血治疗。如果不输血，中风患者发生第二次中风的风险约为70%。通过输血治疗，后续中风的频率至少相对降低85%。本研究的目的是确定输血治疗预防新发缺血性脑损伤（通过脑部MRI测量的显性卒中或无症状脑梗死）的有效性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The major cause of morbidity and mortality in sickle cell anemia is vaso-occlusion. Cerebral infarcts in children with sickle cell anemia may impair motor and/or cognitive function. Overt strokes occurring in patients with sickle cell anemia have been characterized by a sudden and persistent onset of motor deficits, resulting in clear recognition and prompt treatment. However, silent cerebral infarcts, defined as an abnormal MRI image of the brain with increased signal intensity in multiple T2 weighted images and no history or physical finding of a focal neurologic deficit lasting more than 24 hours, are the most common form of neurologic injury in children with sickle cell anemia. The only proven therapy for prevention of overt strokes in children with sickle cell anemia who have already had strokes is blood transfusion therapy. Without blood transfusion, patients who have experienced strokes have approximately a 70% risk of a second stroke. With transfusion therapy, there is at least and 85% relative reduction in the frequency of subsequent strokes. The purpose of this study is to determine the effectiveness of blood transfusion therapy for the prevention of new ischemic brain injury in the form of overt stroke or silent cerebral infarct measured by MRI of the brain.