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.