A 36-year-old woman experienced an excruciating right retro-orbital paroxys
mal headache after a stroke of the anterior two-thirds of the right hemicor
d at the C1 level (anterior spinal artery territory) and the dorsal medulla
(posterior spinal artery territory), A right vertebral artery dissection w
as demonstrated. This unusual infarct mimicked a cluster headache attack or
paroxysmal hemicrania.