Stroke-in-evolution--an indication for an emergency extracranial-intracranial bypass.

The role of the emergency extracranial-intracranial bypass in the management of the stroke-in-evolution is controversial. A case is presented in which the patient's fluctuating clinical picture was influenced by hemodynamic factors. The site of occlusion was inaccessible and an emergency extracranial-intracranial bypass was made to restore cerebral blood flow. The patient made a dramatic recovery after the operation. An emergency extracranial-intracranial bypass may be indicated in carefully selected cases.