Cerberovascular accidents in patients with chronic renal failure undergoing hemodialysis can have serious clinical consequences. We describe a 24-year-old male with tuberous sclerosis who had been on hemodialysis for 14 months and was admitted to our hospital because of suspected subdural hematoma. He underwent surgical removal of the hematoma. Post operative course was without sequelae by the use of peritoneal dialysis as well as hemodialysis with a reduced heparin dosage. Renal angiography revealed hypervascular tumors and polycystic kidney, He had multiple adenoma sebaceum in his face and periungual f ibromas were noticed on toenails. Ophthalmoscopic examination revealed a phacoma in both eyes, As no tumors nor vascular abnormalities were found around the hematoma at the time of surgery, the possibility of underlying tuberous sclerosis as being the etiologic factor of the subdural hematoma appeared remote. Hemorrhagic tendency associated either with renal insufficiency or anticoagulant used with hemodialysis or head trauma were considered as possibly contributing to the cerebral lesion.