Evaluation of Intracranial Cerebral Blood Flow Velocities in Splenectomised and Non-Splenectomised Patients with β-Thalassemia Intermedia Using Transcranial Doppler Sonography

In Vivo. 2015 Jul-Aug;29(4):501-4.

Abstract

Background: A high incidence of clinically-silent cerebral ischemic events has been reported in splenectomised patients with β-thalassemia intermedia (βTI). These could be due to cerebral large-vessel disease. Based on the example of sickle cell disease, we applied transcranial Doppler sonography (TCD) to evaluate cerebral vessels velocity as a possible indicator of cerebral vasculopathy.

Patients and methods: In our study, we included 17 splenectomised and 13 non-splenectomised (control group) patients with βTI. Non-imaging TCD was performed and the time-averaged mean velocity (TAMV) values of cerebral arteries were measured.

Results: There was no statistically significant difference between the two groups concerning age, gender, hemoglobin and hematocrit levels, nor in the TAMV values for all examined vessels (p>0.05). A statistically significant difference was found in platelet count (PLT) (p<0.01) that was higher in splenectomised patients.

Conclusion: Our results do not support the presence of large-vessel vasculopathy in splenectomised βTI patients and agree with recent studies reporting that cerebral ischemic events in these patients might be due to microangiopathy or venous thromboembolism.

Keywords: Beta-thalassemia intermedia (βTI); cerebral vessel vasculopathy; silent cerebral ischemic events; splenectomy; transcranial Doppler (TCD).

MeSH terms

  • Adolescent
  • Adult
  • Blood Flow Velocity*
  • Brain / blood supply*
  • Brain / pathology
  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Splenectomy
  • Ultrasonography, Doppler, Transcranial*
  • Young Adult
  • beta-Thalassemia / complications
  • beta-Thalassemia / diagnostic imaging*
  • beta-Thalassemia / surgery*