Schema for the management of a patient with SCD presenting with focal neurologic deficit. Asterisk (*) denotes when an initial blood transfusion (simple followed quickly by an exchange transfusion) is recommended if the Hb is <10 gm/dL; an exchange transfusion is preferred when it can be expedited, or when Hb >10 gm/dL. CTA, computed tomography angiogram; HSCT, hematopoietic stem cell transplant.