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The authors emphasize the value of extra-intracranial anastomosis prior to occlusion of the cervical segment of the main cerebral arteries, and report a case of carotid-cavernous sinus fistula successfully treated by combined extra-intracranial anastomosis and intra-luminal occlusion of the carotid artery with a balloon catheter.

The authors conclude, on the basis of personal cases and despite several unanswered questions, that the angiographic picture known as Nishimoto's disease, covers two distinct entities, viz. a true congenital disease characterized by arterial stenosis occurring early in embryonal development, with persistence of a patent arterial capillary network at the base of the skull which plays a part as a collateral pathway for the cerebral blood flow, and secondly, angiographic appearances which are similar but unilateral in distribution, related to acquired stenosis of the main arterial trunks. Only the first group should be called Nishimoto's disease.