Nigrostriatal dopaminergic vulnerability in Parkinson's disease: Neuroprotective strategies.

Neurological symptoms are common in children with sickle cell disease (SCD) and are among the most concerning due to their potential to cause significant morbidity and mortality. These neurological manifestations can be acute, such as stroke or transient ischemic attacks (TIA), or chronic, such as cognitive deficits, headaches, and seizures, also contribute to the overall disease burden and can impact the quality of life. Given the complexity of these neurological manifestations, pediatric clinicians need to adopt a comprehensive and systematic approach to the evaluation and management of both acute and chronic neurological symptoms in children with SCD. Our goal is to educate primary care pediatric clinicians with the knowledge and tools necessary for optimizing medical care for children with SCD experiencing acute and chronic neurological morbidity. Based on the neurological chief complaint, the article succinctly synthesizes current knowledge on pathophysiology, clinical presentation, diagnostic strategies, and first-line treatments for neurological complications in children with SCD. Headaches are common in children with SCD. Primary headache disorders such as migraine headaches or tension-type headaches are the most common causes. For migraine alone, more than 1 million people visit the emergency room in the USA annually, and 0.8–2.6% of pediatric emergency room visits are headache related. However, pediatric clinicians must consider and evaluate possible secondary headache disorders (), such as brain hemorrhage and thrombosis, which occur with increased frequency in SCD, and tumors, or infections that can be life-threatening. Primary headache disorders may be debilitating but do not portend a serious underlying medical condition. Obtaining a detailed history and description of the headache to assess for a potential secondary etiology is critical. The mnemonic SNOOP4Y () can be helpful.