Brain imaging features of nontrauma-associated CFE in the setting of sickle cell-related hemoglobinopathies closely resembled those observed in trauma-related CFE. In patients with complex sickle cell-related hemoglobinopathies (Hb-SC and Hb-S/beta-thalassemia) exhibiting unexplained acute neurologic symptoms, radiologists should maintain a high index of suspicion for nontrauma-associated CFE, even with apparently normal initial head CT.