MRI in sickle cell disease. Coronal T1-weighted MRI (A,E) and axial T2-weighted MRI (B-D,F-H) in patients with homozygous SCA. (A-C) Normal MRI in a 19-year-old man with homozygous SCA. (D) Three years later, there is no change. (E-G) Silent infarction (arrows) in the frontal white matter and basal ganglia in a 15-year-old girl with cognitive problems affecting school performance but no acute neurologic presentation. (H) Three years later she has further infarcts with evidence of mild generalized atrophy and had a transient right hemiparesis as well as developing signs of a diplegia.