SILENT CEREBRAL INFARCT MULTI-CENTER TRIAL

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 镰状细胞性贫血的主要致病和死亡原因是血管闭塞。镰状细胞性贫血儿童的脑梗塞可能会损害运动和/或认知功能。镰状细胞性贫血患者发生的明显卒中的特点是突然而持续地出现运动障碍，从而导致明确的认识和及时的治疗。然而，无症状性脑梗塞是镰状细胞性贫血儿童最常见的神经损伤形式。无症状脑梗塞是一种异常的脑部MRI图像，在多个T2加权图像中信号强度增加，并且没有超过24小时的局灶性神经功能缺陷的病史或物理发现。对于已经患过中风的镰状细胞性贫血儿童，唯一被证明可以预防明显中风的疗法是输血疗法。如果不输血，经历过中风的患者大约有70%的风险会再次中风。通过输血治疗，后续中风的频率至少有85%的相对减少。本研究的目的是确定输血治疗对预防新的缺血性脑损伤的有效性，这种新的缺血性脑损伤表现为显性中风或无症状性脑梗塞。

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.