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Management of acute stroke in sickle cell disease

Management of acute stroke in sickle cell disease

SCD: sickle cell disease; IV: intravenous; Hb: hemoglobin; RBC: red blood cell; TIA: transient ischemic attack; IVT: intravenous thrombolysis; MT: mechanical thrombectomy; MRA: magnetic resonance angiography; CTA: CT angiography; CBC: complete blood count; PT: prothrombin time; aPTT: activated partial thromboplastin time; SBP: systolic blood pressure; DBP: diastolic blood pressure; ICH: intracerebral hemorrhage; SAH: subarachnoid hemorrhage; MAP: mean arterial pressure; MRI: magnetic resonance imaging; MRV: magnetic resonance venography; CT: computed tomography.

* Initial stabilization with a rapid clinical assessment should occur simultaneously with prompt RBC transfusion and neuroimaging. In practice, this means that labs required for transfusion are sent while rapid neuroimaging is ordered.

¶ IVT can proceed concurrently with RBC transfusion but should not replace or delay transfusion. Importantly, the apheresis catheter for exchange transfusion must be placed before IVT is administered.
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