Results: mean age 23±8, male / female ratio 1.7/1, clinical admission: 25% intracerebral hemorrhage, 50% cerebral infarction, 25% transient ischemic attack, all cases were brain angiogram and cranial magnetic resonance imaging, Suzuki graded: grade III 75%, rate of grade IV and grade V is 12.5%, total of 12 anastomoses superficial temporal artery and the middle cerebral artery combined indirect bypass: encephalo-myo-synangiosis (EMS).