A sixty three years old male was performed total aortic arch replacement under a separate cardiopulmonary bypass with moderate hypothermia and 600-800ml/min in cerebral perfusion flow which had been getting general consent. A brain ischemia was increased during the operation and the patient was sufferd from brain death. Autopsy revealed the brain edema due to a cerebral transverse sinus thrombus originated by right internal jugular vein thrombosis which was caused by intimal injury by repeated puncture of the vein prior to the operation. This is the first case of accident that occured during the aortic arch surgery.