Headache in cerebral embolic disease.

A patient is presented who had severe headache and then developed a stuttering course of clinical neurological deficits. Arteriography demonstrated an ipsilateral proximal middle cerebral embolus. With recurrence of symptoms, repeat arteriography showed another, more proximal embolus with areas of distal occlusion. The headache probably occurred when the embolus became lodged in a pain sensitive cerebral vessel at the base of the brain. The subsequent stuttering neurological deficits were due to fragmentation of the embolus as well as recurrence.