الفهرس 
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Abstract
Sickle cell anemia (SCA) is one of the most common monogenic disorders in the world, arising from a single point mutation in the beta globin gene (HBB) and leading to haemoglobin polymerisation and abnormal red cell conformation, causing vessel occlusion and ischemia -reperfusion injury.
Stroke is the most sever complication to affect children with sickle cell anemia (SCA). Transcranial doppler (TCD) is an accurate and non-invasive method to determine stroke risk. Randomised controlled trials have demonstrated the efficacy of chronic transfusion therapy in stroke prevention based on risk stratification determined by TCD velocities. This led to the regular use of TCD monitoring for children with SCA in order to determine stroke risk.
TCD is performed for children with sickle cell disease in case of presence of sickle cell anemia with no prior stroke in a child between the ages of 2-16 year or presence of abnormal findings on a previous TCD screening examination (dICA or MCA with velocities of >170cm/sec (Conditional) or>200cm/sec (abnormal).
This study was conducted on twenty patients presenting with sickle cell disease diagnosed by clinical examination and laboratory investigations. Their ages ranging between three and fifteen years from Elhelal Health Insurance Hospital Menoufia, from the period of January 2019 to June 2021.
For all participants, the following was done:
Complete history
Personal, present, past and family history: Specially age, sex, consanguinity, spleenectomy, frequency of blood transfusion and pain rate per year, School performance.
Clinical examination
General examination, Local examination
Laboratory investigation
Complete blood picture (CBC), Kidney function tests, Liver function tests, Serum ferretin.
Speciefic investigation:
Transcranial Doppler Ultrasound
All cases investigated with color doppler ultrasound at El-Helal hospital, named ESAOTE my lab 60 the transducer created the grey scale image at a frequency between 3 – 5.5 MHz and doppler at frequency 5.0 MHz the depth of the image set at 10 cm, sample volume set at 1 mm to 2 mm and the color sensitivity and frame rate are optimized.
In our study of transcranial Doppler ultrasound in children with sickle cell anemia, we found that the patients divided according to the velocity of cerebral blood flow into three groups, (high risk- conditional –normal group).
In the light of the present study findings, it can be concluded that
There is significant difference between presence of TIA and both of ACA and MCA. Both were significantly higher in patients with TIA.