This report describes a case of traumatic carotid-carvernous fistula which presented as an intracerebral hemorrhage. The usual ocular signs were absent due to an atypical drainage pattern from the cavernous sinus. Engorgement of the deep venous system of the brain due to the carotid-cavernous fistula was thought to have caused the intracerebral hemorrhage.

Embolism from an aneurysm is one of the mechanisms involved in the pathogenesis of ischemic symptoms associated with intracranial aneurysms. Four cases are reported in which aneurysms of the internal carotid arteries and middle cerebral arteries were the source of emboli resulting in cerebral infarction. In the treatment of these aneurysms, it is best to clip the neck of the aneurysm with great care to avoid embolism due to extrusion of clot into the distal artery.

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A technique for reconstruction of a cerebral cortical vein which has been sacrificed during an interhemispheric or subtemporal surgical approach is described. The method involves the use of silicone tubing. The author's clinical experience in six patients is summarized.