Recurrent strokes in two siblings with sickle-cell disease and von Willebrand's disease: implications of the role of platelets.

Antiplatelet therapy is known to be beneficial in reducing the incidence of transient ischemic attacks and cerebral infarctions in nonsickling populations. We report two siblings with homozygous sickle-disease and von Willebrand's disease who had recurrent cerebral infarctions (stokes) and transient ischemic attacks despite an inherent inhibitory platelet effect from their vWd and antiplatelet therapy. The development of stroke in patients with sickle hemoglobinopathies and the possible role of platelets and antiplatelet therapy in cerebrovascular accidents in sickle-cell anemia are discussed.