Anastomosis of the superficial temporal to the middle cerebral artery in the management of an intracranial aneurysm. A case report.

A patient with a subarachnoid haemorrhage due to a large right-sided internal carotid artery aneurysm presented unusual problems in management. Direct obliteration of the aneurysm was not possible, while ligation of the internal carotid artery as an alternative form of treatment necessitated the provision of an alternative collateral blood supply to the right cerebral hemisphere, the anterior circle of Willis being deficient. This case illustrates a new surgical technique which has a place in the management of selected cases of cerebral ischaemic disease.