Device Spots Likely Child Stroke Victims : Health: Ultrasound shows characteristic narrowing of arteries in sickle-cell patients. They then can be given transfusion therapy.

A new ultrasound device enables doctors to prevent crippling strokes in children with sickle-cell anemia by identifying the children at greatest risk, a researcher said Wednesday.

Up to 7% of children with sickle-cell anemia suffer strokes that can cause paralysis, said Dr. Robert Adams of the Medical College of Georgia in Augusta.

Until now, doctors have had no way to identify the children at risk until the children had a stroke, Adams said at the annual American Heart Assn. science writers’ seminar.

“If the stroke is devastating, it’s . . . too late,” he said.

The ultrasound machine he has developed “allows you to avoid that first episode,” he said.

The device, called a transcranial Doppler imager, discloses the dangerous narrowing of arteries in the brain that can lead to blockage of the arteries and death of parts of the brain, resulting in a stroke.

Sickle-cell anemia is one of the most serious inherited diseases of black Americans. It occurs in about one in 400 black infants, Adams said.

It produces frequent bouts of pain and fever and damages many of the body’s organs.

Strokes are the most common serious side effects of sickle-cell anemia in children under age 15, Adams said.

He and his colleagues have used the device so far on 250 children, beginning at about age 5, when the chances of a stroke increase.

They have identified 40 suffering from the artery narrowing that can lead to a stroke, Adams said.

Children with sickle-cell disease who suffer strokes are commonly treated with blood transfusions every three to five weeks, Adams said.

If doctors can determine which children are going to have strokes, the transfusion treatment might prevent many of those strokes, Adams said.

Of the patients that he and his colleagues have been following, seven have had strokes. All but one of the seven had previously been identified by the ultrasound device as being at special risk.

The cause of the strokes in children is not known, Adams said. The children develop a narrowing of the arteries that supply blood to the brain. But the narrowing is different from the narrowing of arteries that leads to heart attacks, and doctors don’t know why it occurs.

The transcranial Doppler machine costs about $60,000 to $80,000, which is comparatively inexpensive for a medical instrument, Adams said.

That should allow widespread screening of children with sickle-cell disease once Adams and others have confirmed the device’s effectiveness, Adams said.

“It could prevent hundreds of strokes each year,” he said.

The device “is certainly innovative . . . . I see no reason why it shouldn’t help,” commented Dr. Joy Samuels-Reid, assistant director of clinical services at the Center for Sickle-Cell Disease of Howard University in Washington, D.C.

If transfusion therapy in high-risk children turns out to prevent initial strokes, she said in a telephone interview, “it would be a nice breakthrough.”

The device records the speed of blood through arteries. It identifies the places where narrowing has occurred because the blood must speed up to squeeze through the narrow openings.

Conventional ultrasound scanners that are used to diagnose narrowing of the arteries in the necks of adults are useless when looking for damaged arteries inside the brain because the skull blocks their effect.