Transcranial Doppler screening in sickle cell disease

Why this screen exists

Sickle cell disease is the most common cause of stroke in pediatrics. Individuals with sickle cell disease are at increased risk for vascular disease, especially stroke, and the one screening test that follows from this is transcranial Doppler ultrasonography, TCD.

Who is screened, and when

All sickle cell patients 2 to 16 years of age should be screened with transcranial Doppler ultrasonography (SOR A).

The lower end of that band is what the case is built on: a 2-year-old with a history of sickle cell disease brought in for a well child check is already inside the screening age, so the screen belongs at that visit and not at a later one.