Patient population and characteristics
Seventeen patients with SCD-MMS were included in our study. Twelve
patients (70.6%) of the cohort were female. All patients were initially
managed conservatively. Ten patients in the cohort received surgical
revascularization at a later time (Figure 1). Eight patients (80%) in
the surgical group and six patients (85.7%) in the conservative group
presented with unilateral stroke before beginning conservative medical
management. The average age at first stroke was 6.0 and 8.25 years old
in the conservative and surgical treatment groups, respectively. Of the
remaining patients, two (20%) in the surgical group presented with TIA,
and two (28.6%) in the conservative group were asymptomatic but
presented with an elevated peak flow velocity on Transcranial Doppler
Ultrasound. When comparing the average vasculopathy scores of the left
and right hemispheres, the mean and median score for the surgical group
was 2.89 and 3, respectively. For the conservative group, the mean and
median scores were generally lower, 1.58 and 1.5, respectively. The
differences in pooled (left and right) mean vasculopathy scores between
conservative and surgical groups were found to be statistically
significant (p=0.04). Eight patients (80%) in the surgical group and 5
patients (71.4%) in the conservative group were on aspirin therapy.
Nine patients (90%) in the surgical group and 6 patients (85.7%) in
the conservative group were on iron chelation therapy (Figure 2). These
differences between groups were not statistically significant. Further
characterization of each patient is listed in Table 1.