Abstract Number: Esoc2026a1370 Transcranial Doppler Evaluation in Pediatric Sickle Cell Disease: Two Cases From Equatorial Guinea

Abstract Background and aims Sickle cell disease is associated with a high risk of cerebrovascular events, especially ischemic lesions. From an epidemiological point of view, the prevalence of silent cerebral infarcts is high, reaching approximately 39% at age 18 in patients with more aggressive phenotypes.Transcranial Doppler (TCD) neurosonology is the standard technique for the early detection of arterial stenosis and identification of children at high risk of stroke. Methods We present the case of two patients, aged 6 and 9 years, from Equatorial Guinea, who were previously diagnosed with sickle cell anemia and without known brain lesions. They were referred to our service for neurosonological evaluation using (TCD). Results In the younger patient, the initial study showed increased systolic velocities (SV) in both middle cerebral arteries (MCAs), with asymmetry. In the left MCA, the SV reached 193 cm/s, whereas in the right MCA, it reached 137 cm/s. Based on these findings, a follow-up assessment was performed 15 days later. The SV was 203 cm/s in the left MCA territory and 181 cm/s in the right MCA territory, prompting the initiation of treatment with red blood cell transfusions. The initial assessment of the second patient revealed elevated SV in both MCAs (160 and 175 cm/s, respectively). She was monitored every 15 days, and at the last follow-up, the SV values were 150 and 165 cm/s, respectively. Conclusions TCD is a safe and effective diagnostic method for the early identification of patients at high risk of cerebrovascular events, especially in pediatric patients. Conflict of interest Irene Díaz-Díaz: nothing to disclose Figure 1 - belongs to Results