Context: Stroke is a considerable cause of morbidity and mortality nowadays. It is known the incidence, risk factors and etiology in mid-adults differ notably from older patients. When are young stroke patients, should investigate, besides traditional risk factors, a congenital heart disease, inflammatory and infectious causes, and the use of drugs to prevent new events. Case report: A 29-year-old woman, white, with hypothyroidism and history of surgical resection of retinoblastoma at 3 years of age, with sequelae of bilateral amaurosis, admitted with a history of neurological deficit in the left hemibody, with progression in 14 days until complete left hemiparesis provided. The cranial tomography showed infarction in the territory of the right middle cerebral artery and arteriography showed occlusion of the right internal carotid and dissection of the supraclinoid portion of this artery. Conclusions: While much is known about risk factors, pathophysiology and prognosis of extracranial arterial dissection, data are rare when it comes to the dissection of the intracranial portion of the internal carotid, no case was found that evidenced internal carotid artery occlusion of one side and contralateral dissection. The importance of knowing about the internal carotid dissection is the fact that this etiology is suspected when diagnosis young stroke patients.