The authors describe a case of cerebrovascular accident by syphilis in a 37 years-old man. The clinical features were headache, right hemiparesis and ptosis of the left eyelid. Blood and spinal fluid tests for syphilis were positive. The angiography showed a basilar trunk occlusion with revascularization of the cerebelar culmen. The autopsy disclosed a sub-total occlusion of the basilar artery and a fresh left cerebelar infarct.