Ischemic Stroke in Children With Sickle Cell Disease: A Report of Three Cases and a Review of the Literature

Sickle cell disease (SCD) is an inherited hemoglobin disorder associated with significant morbidity beginning early in childhood.Neurological complications are among the most severe manifestations of the disease.Stroke remains a major complication, leading to permanent neurological deficits, impaired quality of life, and unfavorable long-term outcomes in affected children.We report three cases of ischemic stroke occurring in children aged 8-12 years with homozygous SCD (HbSS).All patients presented with acute focal neurological deficits, including hemiparesis and facial paralysis.Brain imaging confirmed cerebral ischemic lesions, while magnetic resonance imaging (MRI) revealed associated Moyamoya syndrome in one patient.Management included blood transfusions, hydroxyurea therapy, and motor rehabilitation.Despite treatment, one patient experienced recurrent strokes, and another died from acute chest syndrome during hospitalization.These cases highlight the severity of cerebrovascular complications in children with SCD and underscore the importance of early diagnosis, systematic screening, and improved access to specialized diagnostic and therapeutic resources to optimize neurological outcomes in resource-limited countries.