In recent years it has become evident that a number of kinds of cerebrovascular disease can be treated surgically. Thus many neurosurgical groups have reported increasing success in the treatment of saccular aneurysms and arteriovenous malformations. Extracranial occlusion of the carotid or vertebral circulation has been defined as a cause of stroke, and one that can be approached by the surgeon. Carotid endarterectomy appears to be of benefit, particularly in patients with unilateral carotid artery stenosis who are having transient attacks or have a mild-to-moderate neurological deficit.
In 1965, Fisher et al1 called attention to the fact that acute hypertensive cerebellar hemorrhage is another surgical disease—a surgical emergency, in fact. They reported a syndrome which develops over a period of several hours, with prominent symptoms of headache, repeated vomiting, dizziness, and inability to stand or walk. During the acute illness, the patient may be alert. There may be little