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

We thank Dr. Machado for his response to our article.1In 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.2The related images, available in the published case report, show complete occlusion of the patient's intracranial ICAs.2The 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.