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A 38 year old woman presented with a short history of headache, double vision, and rotatory vertigo. Medical history was negative except years of nicotine misuse. Cranial MRI disclosed a large infarction in the area supplied by the left posterior inferior cerebellar artery (PICA).
Occlusion of the left vertebral artery was confirmed by MR angiography.
Five months later, she was again admitted with headache, vomitus, and marked meningism. Cranial CT …