The contribution of ethanol ingestion to brain infarction is unclear, although many studies suggest that the two may be causally related. We report an unusual case of bilateral anterior cerebral artery occlusion in a young female ethanol abuser with sickle-cell trait whose platelets showed hyperaggregability during epinephrine and adenosine diphosphate-induced aggregation experiments. It is concluded that ethanol withdrawal and dehydration along with direct effects of ethanol on platelet aggregation may result in cerebral artery thrombosis. Sickling of red blood cells in the distal circulation also may be a compounding factor, but this is not proven