Brief checklist of our sub-acute care strategy in patients with SCD following an acute stroke
| Steps . | Actions . |
|---|---|
| 1. | Discuss MRI results with the patient/family face to face in clinic |
| 2. | Refer to neurologist to confirm new baseline for any focal neurologic deficit |
| 3. | Refer to psychologist for testing to identify cognitive strengths and weaknesses, and determine the need for school/workplace accommodations. Domains to assess include: |
| General intellectual functioning | |
| Attention | |
| Memory | |
| Speed of information processing | |
| Executive function | |
| Visual-motor skills | |
| Academic achievement | |
| Behavioral and emotional adjustment | |
| 4. | Meet with patient and/or family to discuss results of #2, #3, and treatment recommendations when appropriate, based on patient’s/parents’ wishes, cognitive test scores, and school/work performance |
| Blood transfusion therapy | |
| Hydroxyurea in special circumstances | |
| Advocate for written IEP or workplace accommodations | |
| Adults are referred to vocational and/or neurologic rehabilitation programs | |
| 5. | Perform annual MRI/MRA to evaluate for new infarcts or progressive vasculopathy. If signs of progression are seen, then discuss about alternative therapies including SCT, if already started on regular blood transfusion therapy. |
| Steps . | Actions . |
|---|---|
| 1. | Discuss MRI results with the patient/family face to face in clinic |
| 2. | Refer to neurologist to confirm new baseline for any focal neurologic deficit |
| 3. | Refer to psychologist for testing to identify cognitive strengths and weaknesses, and determine the need for school/workplace accommodations. Domains to assess include: |
| General intellectual functioning | |
| Attention | |
| Memory | |
| Speed of information processing | |
| Executive function | |
| Visual-motor skills | |
| Academic achievement | |
| Behavioral and emotional adjustment | |
| 4. | Meet with patient and/or family to discuss results of #2, #3, and treatment recommendations when appropriate, based on patient’s/parents’ wishes, cognitive test scores, and school/work performance |
| Blood transfusion therapy | |
| Hydroxyurea in special circumstances | |
| Advocate for written IEP or workplace accommodations | |
| Adults are referred to vocational and/or neurologic rehabilitation programs | |
| 5. | Perform annual MRI/MRA to evaluate for new infarcts or progressive vasculopathy. If signs of progression are seen, then discuss about alternative therapies including SCT, if already started on regular blood transfusion therapy. |