Brain

Hi,

In all our discussions about thal complications or iron overload, we never mentioned the brain. Almost all organs may or may not be affected  indirectly by thal: heart, liver,spleen,bones, bone marrow, endocrine glands, hormonal glands (diabitis), kidneys, gall bladder even we have leg ulcers, but we never mention any thing about the brain complications or iron overload in brain.

What so special about it?? OR It only takes a longer time to be affected more than the other organs???


Manal

Hi Manal ,

I think that we often spoke about depression or Manic depressive illness common in some thal patient and to my undestanding it involves the brain organ.
On our web-site we have few people that has posted messages  about their depressions. thus we still disassociated our thinking ,that is because the brain was not mentioned as such.
due to the lack oxygen most of our organs get affected at one time or another.It just a vicious circle.
I hope every one is doing the best they can and I wish you all good luck.
 As for myself ,I'm looking forward, to attend my sons wedding tommorow,I'm so gratefull to be alive for that event.
Kathy

Hi Manal,

it's a really thoughtful question,i feel stupid why i didn't even think about that my self, so i searched on internet and i came across this, please i am not sure about the authenticity of source,, i think Andy might be of any help in this aspect, i am quoting it here,it worries me a bit, but what can we do ??nothing other then being care ful and on watch.

love you,

ZAINI.

http://cat.inist.fr/?aModele=afficheN&cpsidt=1185974

Titre du document / Document title
MR imaging of the brain : Findings in asymptomatic patients with thalassemia intermedia and sickle cell-thalassemia disease
Auteur(s) / Author(s)
MANFRE L. (1) ; GIARRATANO E. (2) ; MAGGIO A. (3) ; BANCO A. (1) ; VACCARO G. (2) ; LAGALLA R. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Institute of Radiology P. Cignolini, University of Palermo, via del Vespro 127, 90143 Palermo, ITALIE
(2) Department of Radiology, St. Elia Hosp., corso Umberto 133, 93100 Caltanissetta, ITALIE
(3) Department of Thalassemia, Cervello Hospital, via Trabucco 1, 90144 Palermo, ITALIE

Résumé / Abstract
OBJECTIVE. The purpose of this study was to evaluate the spectrum of MR findings of the brain in asymptomatic patients affected with thalassemia intermedia or sickle cell-thalassemia disease to prevent brain damage by identifying patients at risk for stroke so that transfusional or pharmacologic treatment could be implemented. SUBJECTS AND METHODS. Forty-one asymptomatic patients who were younger than 50 years and were affected by minor hemoglobinopathies underwent MR imaging of the brain. Ischemic lesions were classified as small, medium, or large and as single or multifocal. Atrophic changes were graded subjectively as mild, moderate, or severe. A grade of brain damage was assigned to every patient. The frequency and severity of brain damage were correlated with the number of sickle-cell crises per year, hemoglobin level, sickling hemoglobin level, platelet count, sex, and age. RESULTS. Of the patients with thalassemia intermedia, 37.5% showed asymptomatic brain damage, and 52% of those with sickle cell-thalassemia disease showed asymptomatic brain damage. In the thalassemia intermedia group, atrophy was always mild and ischemic lesions were generally small (25%) and single (25%). Among the patients with sickle cell-thalassemia disease, 24% had small, 16% had medium, and 12% had large ischemic lesions. Multifocal lesions were twice as common in the patients with sickle cell-thalassemia disease (20%) as in those with thalassemia intermedia (12.5%). Only in the patients with thalassemia intermedia did the frequency of brain damage increase with age. Moreover, brain damage inversely correlated with hemoglobin level in patients with thalassemia intermedia but not in those with sickle cell-thalassemia disease. Brain damage was more severe in patients with sickle cell-thalassemia disease who had more crises per year. CONCLUSION. This study suggests that patients with thalassemia intermedia and those with sickle cell-thalassemia disease may have asymptomatic brain damage. Our results suggest that MR imaging is useful in identifying patients at risk for stroke so that they can be treated with transfusional or pharmacologic therapy.
Revue / Journal Title
American journal of roentgenology  (Am. j. roentgenol.) 

Hello Zaini.
Thank-you for that piece of information
That was an excellent piece of research  and its an eye opening issue.

LOL,  I always wondered about my sanity, now it make more sense.

Thanks to all of you for the good wishes.
 Sajid  this is a lovely card it is appreciated.
Manal I like your anthusiasm and your zest for life.
 I will post a photo when I get it,and will share the wedding  story with you  all.
you are the best friend that an older girl can ever have, love you all. take care ,
kathy

christian is sickle cell thal and due to the risk of a clot in the brain causing a stroke this was the main reason we went down the transfusion path.

vic