Multiple cerebral infarctions occurred in a 32-year-old man with both basilar artery and hemiplegic migraine. One event was associated with decrement of propranolol dosage. Platelet aggregation, coagulation studies, and other laboratory studies were normal. Computerized tomography revealed several areas of both old and new infarction. The relationship of the migraine attacks to the brain infarcts remains circumstantial, but migraine was the only identifiable cause of the infarcts in this patient.