Brain with sickle-shaped cells over Africa

Sickle Cell Disease and the Brain: Unmasking Neurological Risks in Africa

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"A systematic review reveals the silent threats of sickle cell disease, calling for proactive screening and management strategies to protect vulnerable populations."

Sickle cell disease (SCD) is a significant public health concern in Africa, where it's associated with high rates of illness and death. Beyond the well-known physical symptoms, SCD can lead to serious neurological complications, impacting patients' quality of life and placing a heavy burden on families. Unfortunately, there are gaps in our understanding of how SCD affects the brain in African populations.

Imagine a child with SCD struggling not only with pain crises but also with silent strokes or cognitive difficulties that go unnoticed. These neurological issues can lead to learning disabilities, behavioral problems, and reduced overall well-being. Because these complications aren't always obvious, they often go unmanaged, leading to long-term consequences.

To address this critical gap, researchers conducted a systematic review, pooling data from various studies to estimate the prevalence of neurological complications in African individuals with SCD. The goal is to provide a clearer picture of the problem, inform healthcare policies, and guide future research efforts to improve the lives of those affected.

The Silent Threat: Unveiling Neurological Complications

Brain with sickle-shaped cells over Africa

Neurological complications in SCD arise from vaso-occlusion and hemolysis. The polymerization of deoxy-hemoglobin S results in inflexible, sickle-shaped red blood cells that block small blood vessels. This can cause a range of issues:

These blockages lead to a variety of neurological problems, affecting both children and adults. While overt strokes are recognized, subtler issues like silent infarcts and cognitive impairment are often missed. These can significantly impact a child's development and a person's ability to function in daily life.

Stroke (Ischemic or Hemorrhagic): Blocked blood flow deprives the brain of oxygen, causing damage.
Silent Cerebral Infarcts: Small, often unnoticed areas of damage that can accumulate over time.
Cognitive Impairment: Difficulties with memory, attention, and learning.
Seizures: Disrupted electrical activity in the brain.
Chronic Headaches: Persistent pain that can affect concentration and quality of life.

It's important to note that the relative frequency of vascular versus non-vascular complications may differ in African populations compared to other parts of the world. This review aims to provide a more accurate estimate of these complications in the African context.

Turning Knowledge into Action: A Call for Proactive Care

This systematic review highlights the urgent need for increased awareness and proactive management of neurological complications in African individuals with SCD. By quantifying the burden of these complications, we can inform policymakers and healthcare providers, leading to better screening programs and treatment strategies.

The findings emphasize that neurological damage often begins early in life, underscoring the importance of early detection and intervention. Regular neuropsychological assessments and neuroimaging studies should be considered, even in asymptomatic patients, to identify silent infarcts and cognitive deficits.

While this review provides valuable insights, further research is needed to address the specific challenges of managing SCD in Africa. These challenges include limited resources, inadequate screening, and regional differences in healthcare standards. By addressing these gaps, we can improve the lives of those living with SCD and protect their neurological health.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1136/bmjopen-2016-012981, Alternate LINK

Title: Neurological Complications Of Sickle Cell Disease In Africa: Protocol For A Systematic Review

Subject: General Medicine

Journal: BMJ Open

Publisher: BMJ

Authors: Michel K Mengnjo, Joseph Kamtchum-Tatuene, Nicolas Nicastro, Jean Jacques N Noubiap

Published: 2016-10-01

Everything You Need To Know

What types of neurological problems can arise from sickle cell disease?

Sickle cell disease can lead to several neurological complications, including overt strokes, silent cerebral infarcts, cognitive impairment (affecting memory, attention, and learning), seizures (due to disrupted electrical activity in the brain), and chronic headaches. These complications arise primarily from vaso-occlusion and hemolysis, where sickle-shaped red blood cells block small blood vessels, depriving the brain of oxygen and causing damage. Early identification and management are crucial to minimize long-term neurological consequences.

What are 'silent cerebral infarcts' related to sickle cell disease, and why are they a concern?

Silent cerebral infarcts are small areas of brain damage that often go unnoticed, without any immediate or obvious symptoms. However, over time, these infarcts can accumulate and lead to significant cognitive impairment, learning disabilities, and behavioral problems, especially in children with sickle cell disease. Regular screening and monitoring are essential to detect and manage these silent threats, preventing long-term neurological consequences.

What 'gaps' exist in addressing sickle cell disease neurological complications in Africa, and what actions are recommended?

The systematic review highlights a significant gap in understanding and managing neurological complications of sickle cell disease in African populations. It calls for increased awareness among healthcare providers and policymakers, advocating for better screening programs, improved access to healthcare, and further research tailored to the specific needs of African individuals with sickle cell disease. These efforts aim to reduce the burden of neurological complications and improve the quality of life for those affected.

How do 'vaso-occlusion' and 'hemolysis' contribute to neurological complications in sickle cell disease?

Vaso-occlusion occurs when inflexible, sickle-shaped red blood cells block small blood vessels, restricting blood flow and oxygen supply to the brain. Hemolysis, the destruction of red blood cells, contributes to inflammation and further impairs blood vessel function. These processes lead to neurological complications such as strokes and cognitive impairment. Understanding these mechanisms is crucial for developing targeted therapies to prevent or mitigate neurological damage in individuals with sickle cell disease.

Why is early screening so important in managing the neurological risks associated with sickle cell disease?

Early, proactive screening is essential to identify neurological complications like silent cerebral infarcts and cognitive impairment, which are not always immediately apparent. Regular monitoring and timely interventions, such as blood transfusions or hydroxyurea, can help prevent further brain damage and improve neurocognitive outcomes. This proactive approach is vital for enhancing the quality of life and long-term well-being of individuals with sickle cell disease.