The incidence of kinking and coiling of the internal carotid artery in an unselected series of 1,010 angiographies is reported. The angiographies of patients with cerebrovascular insufficiency and those of patients with other brain diseases were separately reviewed. On the basis of a statistical comparison, the finding of kinks and coils appears significantly higher in "vascular" than in "non-vascular" patients. The greater difference concerns age subgroups up to 50 years. These data give support to the assumption that both kinking and coiling of the internal carotid artery may play a role in determining cerebral ischemic attacks. Surgical experience concerns a series of 19 patients operated by various corrective procedures, including resection of the internal carotid artery and end-to-end anastomosis. It is felt that surgery, performed in appropriately selected cases, can afford significant benefits to cerebrovascular patients, especially those presenting recurrent ischemic episodes.