The creation of a scalp A.V fistula followed by an STA-MCA vein graft bypass: a case report. 
A thirty-two-year-old male developed multiple neurologic symptoms.  Medical evaluation disclosed hypertension, obesity, and a type IV hyperlipoprotein electrophoresis.  A nuclear cerebral arteriogram showed reduced flow in the right middle cerebral artery.  Arteriographic examination revealed an occlusion at the origin of this artery.  The ipsilateral superficial temporal artery was too small to be used in an EC-IC bypass procedure.  To correct these conditions, a two-stage procedure was performed.  First, an arteriovenous fistula was created between the superficial temporal artery and its accompanying vein.  Second, four and one-half months later, the temporal vein, which had by then enlarged, was resected and grafted from the proximal superficial temporal artery to the right angular artery.  Angiography three months after the latter procedure showed that the anastomosis was patent.