Basilar artery occlusion (BAO) remains one of the most devastating strokes we face, and treatment decisions often stretch beyond the familiar anterior‑circulation playbook. This study, TRACE‑5, takes a bold step into that uncertainty, testing Tenecteplase in BAO patients presenting up to 24 hours from symptom onset. Join Dr. Onuzuruike as he unpacks the trial’s design, its surprising and practice‑shaping findings, and what this study might mean for the future of posterior circulation stroke care.