Author Response: Distribution of Silent Cerebral Infarcts in Adults With Sickle Cell Disease

We thank Dr. Machado for his response to our article.¹ In his comment, Dr. Machado described a case they observed in which a 15-year-old adolescent patient with sickle cell disease (SCD) presented with a minimally conscious state and severe bilateral internal carotid artery (ICA) vasculopathy resulting in massive bihemispheric strokes.² The related images, available in the published case report, show complete occlusion of the patient's intracranial ICAs.² The patient's history indicated that, from the time they were 1 year, they experienced recurrent clinical strokes with loss of consciousness and right and left hemiparesis and that they achieved partial recovery.