Background.- The importance of dissections in young stroke patients have been emphasized cur¬rently. Carotis artery dissections are more frequ¬ent than the vertebral artery. The clinical picture of vertebro-basilar artery dissections is one of an occlusion of intracranial arteries. In this' article, the clinical features and evaluation of a young st¬roke patient due to vertebral artery dissection and the value of intra-arterial thrombolytic therapy has been debated. Observation.- Forty-two years old male patient was brought to emergency room. The patient had clinical features of a sudden onset brain stem dys¬function. An early CT scan revealed a hyperdensity over the basilar artery suggestive of a basilar ar¬tery trombosis. In order to find out the etiology and to treat this young onset stroke patient, an angiography was performed revealing a vertebral artery dissection and a basilar artery trombosis se¬condary to this dissection. Three hours after the insult, he was treated with intra-arterial urokina-se. An early recovery was observed.