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Van der Vaart, who has become the club's new talisman since his summer move from Real Madrid, failed to train on Tuesday morning and went for a scan on an ankle knock.
Fellow midfielder Bale, whose Champions League exploits this season have made him one of the most talked-about players on the planet, is suffering with a shoulder injury picked up in Saturday's north London derby.
Manager Harry Redknapp appeared more optimistic this afternoon about the latter's chances of being fit but admitted Van der Vaart was "struggling".
"Obviously, he'd be a big loss to us - he's been in great form," said Redknapp, before pointing out the Holland international's loss would be offset by the recent return of striker Jermain Defoe from injury.
"Jermain Defoe's coming back as well, so that's a big bonus for us. Whether I start him or bring him off the bench, he'll play a part in the game for sure."
Van der Vaart and Bale were instrumental in Saturday's amazing comeback at the Emirates Stadium, which saw Spurs end a 17-year wait for victory at the home of their arch-rivals. And Redknapp is hoping his side carry the euphoria from that victory into the match.
"Knowing what it means to everybody associated with this club - the fans, the players, everybody who follows the club - to go to the Emirates and win as we did at the weekend must give us great confidence," he said.
"Hopefully, we can carry that through tomorrow night and really make it a springboard from here to push on for the rest of the season."
Bale's recent performances have caught the eye of Werder Bremen right-back Clemens Fritz, who insists he is ready to face "the best" at White Hart Lane. Bale arguably got the better of their individual battle in the reverse fixture at the Weserstadion two months ago, even though the match itself ended 2-2.
Fritz said: "He's a great player. In the rankings I think he's one of the fastest players of all. He scores goals, he's proven himself over the last few weeks, and he's very dangerous in his position.
"But we're here, we're playing Champions League and we have to measure ourselves against the best."
The German side arrive in the midst of an injury crisis and a miserable run of form. Ten players are missing, with Petri Pasanen (virus) joining the likes of captain Torsten Frings and strikers Claudio Pizarro and Marko Arnautovic on the sidelines.
Coach Thomas Schaaf has included several players from the club's Under-23 side to make up the numbers in a squad which has conceded 10 goals in their last two away games.
Source: DSG
Source: DSG