Stroke, migraine and intracranial aneurysm: a case report.

A man had since childhood recurrent attacks typical of ophthalmic migraine. After an otherwise unremarkable attack, he was left with a permanent quadrantanopsia due to a right occipital infarct. The remarkable pattern of progression, which characterized the visual phenomenon of subsequent attacks, favours a primary neuronal phenomenon. The first angiography revealed an occlusion of the posterior cerebral artery (PCA) but the second one, performed two years later, disclosed a PCA aneurysm. Such a finding emphasizes the need of thorough and repeated evaluations of patients with so-called "migrainous infarcts."