The history of cerebral arteriography has repeatedly reaffirmed the values as well as the dangers of this diagnostic technique. The advent of surgical therapy for extracranial cerebral vascular disease necessitated new arteriographic methods which would permit visualization of as much as possible of the cervical-cerebral vasculature. Despite the widespread use of brachial arterial injections or catheterization for this purpose, direct injection of the left common carotid is still usually necessary in addition, for the brachial injection techniques rarely provide adequate visualization of this vessel. Further, it is still necessary to employ direct carotid puncture arteriography for that sizeable group of patients in whom it is desired to visualize intracranial vessels in detail. For these reasons it is still important to consider the dangers of cerebral angiography, for its value as a diagnostic tool is widely accepted. The statistical incidence of complications from cerebral arteriography is fairly well documented.,1-10 The