[Extra-intracranial anastomosis technic]

This is a report about the author's surgical experiences with extra-intracranial anastomosis. Special attention is drawn to various technical measures for avoiding postoperative complications. It seems very important to leave around the temporal superficial artery a mantle of connective tissue to preserve the vascular supply of the vessel wall and to facilitate safe manipulation of the artery. Further more the report deals with the bloodflow direction in the temporal superficial artery in relation to the middle cerebral artery- the flow should be directed to the trunk of the middle cerebral artery in order to effect an optimal perfusion of the supplying area of the middle cerebral artery. Approx. 8 to 10 mm should hold the incision in both arteries, end of temporal superficial and side of middle cerebral, to attain a wide opened junction between both arteries and to prevent obstruction. Attention is called to the risk of skin necrosis when using both, frontal and parietal branches of the temporal superficial artery. High value is set on covering the bone and dura deficiency with muscle lobe to prevent spreading and fistula of cerebral spinal fluid.