After brief comments about the angiographic findings on 298 consecutive cases of isquemic or hemorrhagic cerebral vascular strokes, cerebral angiography is emphasized as the main diagnostic method, owing to the variety of physiopathogenic and ethiologic factors involved in the genesis of this syndromes. The results of surgical treatment on eleven patients with spontaneous intracerebral hematomata are discussed in detail. Despite the great divergence among the authors about the management of massive intracerebral hemorrhage, the rapid improvement in 54,6% of the patients in this series, in our opinion justifies surgery in the majority of the cases.