Introduction. Patients with β-thalassemia intermedia have a higher incidence of thromboembolic events compared to the general population. Previous studies have shown that patients with sickle cell disease, who are also prone to ischemic events, have higher intracranial arterial blood flow velocities measured by transcranial Doppler sonography (TCD). The aim of this study is to evaluate intracranial arterial flow velocities in patients with β-thalassemia intermedia and compare the results with those found in healthy subjects. Methods. Sixty-four patients with β-thalassemia intermedia and 30 healthy subjects underwent transcranial Doppler sonography. Results. Significantly higher flow velocities were found in intracranial arteries of patients compared to controls (P = 0.001). Previously splenectomized patients with thrombocytosis showed higher flow velocities than nonsplenectomized patients without thrombosis. Conclusion. The increased flow velocities in patients with β-thalassemia intermedia may point to a higher risk of ischemic events. Preventive measures such as blood transfusion or antiplatelet treatment may be beneficial in these patients.

We aimed to compare cerebral artery velocity and relevant clinical factors in patients with β-thalassemia intermedia (β-TI), β-thalassemia major (β-TM), and healthy individuals. For this study, 60 patients with β-TM and 64 with β-TI were randomly selected. Sixty healthy adults comprised the control group. Time average maximum mean velocity (TAMMV) was measured in large cerebral arteries with transcranial Doppler (TCD) ultrasonography. In all arteries, TAMMV was significantly higher in the β-TI group than that of β-TM or controls (P < .001). Patients with β-TM had significantly higher TAMMV than controls in most arteries evaluated (P < .001). Overall, the lack of regular blood transfusions, splenectomy, and lower age (to a lesser extent) was found to be independent influencing factors contributing to high cerebral artery velocities. Further detailed longitudinal studies are needed to confirm these results and to determine the risk of silent infarction and stroke in patients with thalassemia and abnormal TCD, with particular focus on patients with β-TI.

Serum level of ionized calcium in patients with migraine during a migraine attack and times without migraine Mojtaba Kazemi (1) Sajad Emami (2) Aida Bahman (1) Mahshid Zareian (1) Abdolreza Sotoodeh Jahromi (2) Somayehsadat Talebnia Jahromi (2) Hassan Zabetian (2) Ali Golestan (3) Abdolhossein Madani (4)

No abstract

3335 Introduction: Patients with β-thalassemia, especially β-thalassemia intermedia (β-TI), are prone to hypercoagulable state and subsequently cerebral thromboembolic events. In this study we aimed to determine cerebral artery velocity as a determinant of stroke risk in patients with β-TI compared to β-thalassemia major (β-TM) and healthy subjects. Method: Sixty patients with β-TM and 64 β-TI were randomly selected in this cross sectional study. Sixty healthy adults comprised as a control group. The Time average Maximum Mean Velocity (TAMMV) was measured in large cerebral arteries using Transcranial Doppler (TCD) Ultrasonography. The TAMMVs in different arteries were compared between the patients with β-TI, β-TM and controls. Results: TAMMV in all arteries was significantly higher in β-TI patients than β-TM patients and controls (P< 0.001). Also β-TM patients had significantly higher TAMMVs than controls in all arteries except for the left and right posterior cerebral arteries (P< 0.001). In univariate analysis we found that the lack of transfusion, thrombocytosis, splenectomy, higher platelet counts and lower age could contribute to increase TAMMV (P< 0.05). However, in the multiple linear regression models the only important factors influencing TAMMV were the lack of transfusion in all evaluated arteries following with age only in some investigated arteries. Conclusion: We showed that patients with β-TI has a higher TAMMV in comparison with the healthy subjects as well as with the β-TM patients probably due to the lack of transfusion and chronic anemia. In addition, β-TI patients are more prone to thromboembolic events and subsequently cerebral infarction due to hypercoagulable state. We recommend MRI screening in β-TI patients for detection of silent lesions, in the presence of asymptomatic lesions, TCD would be beneficial. In patients with high cerebral artery velocity and silent lesion further evaluation, close observation and prophylactic treatment including regular blood transfusion and antiplatelet therapy should be considered. However further prospective studies are suggested to confirm the correlation between the stroke risk and high cerebral velocity as well as the protective effect of regular transfusion in β-TI patients. Disclosures: No relevant conflicts of interest to declare.