A 5-year-old child with sickle cell disease (HbSS) is asymptomatic with no history of stroke. Which screening modality is recommended for primary stroke prevention?

• A MRI brain annually
• B Carotid Doppler
• C MR angiography
• D Transcranial Doppler ultrasonography ✓

Explanation

The STOP trial established transcranial Doppler (TCD) ultrasonography as the screening tool for primary stroke prevention in children with HbSS. Time-averaged mean maximum velocities above 200 cm/s in the internal carotid or middle cerebral artery indicate high stroke risk and benefit from chronic transfusion therapy. MRI and MRA are not first-line screening tools.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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