RT Journal Article SR Electronic T1 Cerebrovascular disease in sickle cell disease JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP practneurol-2022-003440 DO 10.1136/pn-2022-003440 A1 Vafa Alakbarzade A1 Chinedu Maduakor A1 Usman Khan A1 Nader Khandanpour A1 Elizabeth Rhodes A1 Anthony C Pereira YR 2022 UL http://pn.bmj.com/content/early/2022/09/19/pn-2022-003440.abstract AB Sickle cell disease (SCD) is the most common type of hereditary anaemia and genetic disorder worldwide. Cerebrovascular disease is one of its most devastating complications, with consequent increased morbidity and mortality. Current guidelines suggest that children and adults with SCD who develop acute ischaemic stroke should be transfused without delay. Those with acute ischaemic stroke aged over 18 years who present within 4.5 hours of symptom onset should be considered for intravenous thrombolysis; older patients with conventional vascular risk factors are the most likely to benefit. Endovascular thrombectomy should be considered carefully in adults with SCD as there are few data to guide how the prevalence of cerebral vasculopathy may confound the expected benefits or risks of intervention. We present a practical approach to cerebrovascular disease in sickle cell patients based on the available evidence and our experience.Data are available upon reasonable request.