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CHAPTER 47 Doppler Sonography of the Brain in Children 1603

POST CA

M

A

P

A

B

C

D

E

FIG. 47.9 Acute Stroke in 3-Year-Old Boy With Sickle Cell

Disease, With Acute Slurred Speech and Left-Sided Weakness.

(A) Normal TCD color low through temporal bone of left

MCA (M), left ACA (A), and left PCA (P). (B) Right temporal TCD

sonogram shows no right MCA, normal right PCA (orange), and

normal left PCA (blue). (C) Doppler waveform of the right ophthalmic

artery (OA) shows increased diastolic low. (D) Axial 3D

time-of-light MR angiogram shows absent low in the right MCA

and a prominent right OA (arrow). (E) Axial proton-density-weighted

image shows absent M1 segment of the right MCA and hyperintense

area in the right frontal lobe, compatible with acute

infarction. (With permission from Seibert JJ, Miller SF, Kirby RS,

et al. Cerebrovascular disease in symptomatic and asymptomatic

patients with sickle cell anemia: screening with duplex transcranial

Doppler US—correlation with MR imaging and MR angiography.

Radiology. 1993;189[2]:457-466. 66 )

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