Old multi-territory infarcts in the setting of sickle cell disease

Case contributed by Suraindra Mark Rajadurai
Diagnosis certain


Presents with headache and photophobia.

Patient Data

Age: 25 years
Gender: Female

Multiple areas of encephalomalacia involving the parieto-occipital regions and cerebellum most in keeping with old multi-territory infarcts. 

Admission chest radiograph


Lungs and pleural spaces are clear. Cardiomediastinal contour is normal.

Day 3 chest radiograph


New right sided pleural effusion, interestitial opacity 

Case Discussion

Stroke in children and young adults can result from a number of causes.

In this case, the patient had a documented history of sickle cell disease diagnosed at age 6 and treated with hydroxyurea. She had a past history of multiple cortical infarcts as a child as a complication of her sickle cell disease. 

In this case the rapid development of new pulmonary changes represented an acute chest syndrome in the context of the patient's underlying sickle cell disease. 

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