The association between migraine and stroke is well known. It is assumed that 15% of strokes in patients below 45 years are due to migraine. To evaluate the features of this association, we have reviewed seven cases of patients with migraine and established neurological deficits. All patients fulfilled the following criteria: 1) past history of migraine, defined on the basis of the classification by the International Committee for the Classification of Headache; 2) temporal association between a migraine episode, similar to previous ones, and the ischemic episode, and 3) absence of other concomitant diseases that might result in stroke. We evaluated the age at the onset of migraine, its type, familial history of migraine (particularly of migrainous accompaniments), vascular risk factors, mode of onset, and type and duration of neurological deficit. In all cases, cranial CT, EEG, echocardiogram, serologic tests for syphilis, autoantibody investigation, routine laboratory tests and nuclear magnetic resonance (in four patients). In five cases cerebral arteriography was carried out, and arterial occlusion was demonstrated in one. We conclude that, in spite of its low frequency, migraine may result in cerebral ischemic episodes, although the relevant pathogenetic mechanisms are not yet well understood.