A 67-year-old woman suddenly complained of severe head-ache and motor weakness on her left side on August 3rd, 1977. As left side hemiplegia and speech disturbance continued, she was admitted to hospital, where a right carotid angiograghy was performed and the vascular network at the base of the brain was revealed. On August 16th, 1977, she was transferred to our clinic for operation. On admission, she was in a clear state of consciousness but slightly disoriented. There were hemiplegia with pathological reflexes on her left side. On bilateral carotid angiography and Ctscan, the right sided basal Moyamoya with intracerebral hematoma in the putaminal region was revealed…