RT Journal Article SR Electronic T1 Recurrent transient heading disorientation heralding acute posterior cerebral artery (PCA) infarction JF BMJ Neurology Open JO BMJ Neurol Open FD BMJ Publishing Group Ltd SP e000009 DO 10.1136/bmjno-2019-000009 VO 1 IS 1 A1 Yong Chuan Chee A1 Beng Hooi Ong YR 2019 UL http://neurologyopen.bmj.com/content/1/1/e000009.abstract AB Objective Heading disorientation is a type of pure topographical disorientation. Reported cases have been very few and its underlying mechanism remains unclear. We report an unusual presentation of a 60-year-old man with recurrent transient heading disorientation heralding an acute posterior cerebral artery infarction.Design Case report.Conclusion Acquired injury to the right retro-splenial region can result in a specific variant of topographical disorientation known as heading disorientation that may present as an atypical transient ischaemic attack-like symptom heralding acute cerebral infarction.