Skip to main content
AAPM&R 2025 Main banner
JFK
Final Program


Official Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
On Demand
On Demand
In-Person
In-Person
Livestream
Livestream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Rate ePoster

Neurological Rehabilitation

Acute ischemic infarction and subsequent complications in a patient with Hemoglobin SC disease

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 5

    Poster Presenter(s)

  • David Hopkins, MD

    Resident Physician
    Albert Einstein Healthcare Network/MossRehab PM&R Program
    Philadelphia, Pennsylvania

    • Co-Author(s)

  • MA

    Mollie E. Andreae, MD

    Physiatrist
    Jefferson Moss Magee Rehabilitation
    Philadelphia, Pennsylvania

Disclosure(s):
David Hopkins, MD: No financial relationships to disclose
Case Diagnosis: Acute ischemic infarction in a patient with Hemoglobin SC disease

Case Description or Program Description: A 42-year-old male with sickle cell trait, hypertension, hyperlipidemia, and prostate cancer underwent elective prostatectomy. The morning after the surgery, the patient was noted to have right-sided weakness and expressive aphasia. Imaging revealed a left M1 occlusion and left middle cerebral artery infarction for which he underwent mechanical thrombectomy. Further hematological workup revealed a diagnosis of hemoglobin SC (HgbSC) disease, rather than sickle cell trait. The patient underwent red blood cell exchange prior to being discharged to acute inpatient rehabilitation (AIR).

Setting: Acute care hospital, Acute inpatient rehabilitation

Assessment/Results: While at AIR, he showed significant functional improvements, but on the day prior to discharge home, he developed acute worsening of aphasia and right hemiparesis requiring acute transfer out. Imaging showed intraparenchymal hemorrhage resulting in placement of extra-ventricular drains (EVD), but due to persistent clotting and obstruction of the EVD’s, he underwent decompressive craniectomy. The patient’s course in acute care and AIR was further complicated by multifocal deep vein thrombosis (DVT) requiring IVC filter placement and right hip avascular necrosis (AVN). During his AIR stay, Hematology was reconsulted and recommended RBC exchange every 6 weeks, with possible initiation of hydroxyurea in the future.

Discussion (relevance): While symptoms may be less severe than in Sickle Cell disease, patients with HgbSC disease still face significant morbidity and mortality, especially after age 30. HgbSC disease can cause a variety of complications stemming from its hypercoagulable state. In addition to stroke symptoms, patients should be closely monitored for hypercoagulable complications including DVTs, AVN, leg ulcers, and retinopathy.

Conclusions: This case highlights the importance of screening and management of patients with HgbSC disease. The rehabilitation team should ensure proper management of HgbSC and monitor for potential complications that may arise during the rehabilitation course.