A 32-year-old woman with a history of brain irradiation 11 years ago for occipital ependymoma presented 3 events of migraine-like headache associated with hemiparesis without loss of consciousness, cyclically with spontaneous resolution. In a fourth event, a generalized crisis with motor compromise is added. She underwent cerebral spinal fluid, hematological and biochemical studies, being negative for metabolic disorders or neoplasia, while imaging studies revealed posterior temporal, parietal and occipital cortical thickening. Along with the results, post-radiotherapy stroke-like migraine attack syndrome (SMART) was diagnosed. This clinical case presents a rare late complication of brain irradiation, studied with serial magnetic resonance imaging.