Cerebral stroke is an extremely common disease which strikes suddenly and leaves its victims in a seriously disabled state; its prevention remains a medical problem of the highest priority. Though the techniques for neurosurgical treatment following onset were already considered at the beginning of this century when the first surgical attempts were made, there is still room for significant developments in this area.
Computed tomography and microsurgical techniques have become major weapons in the surgeon's armory and notable advances have been made in the surgical therapy of cerebral infarction and hypertensive intracerebral hemorrhage. However, the surgical treatment of cerebral stroke-whether due to aneurysm, AVM, or other mechanisms-has been limited to therapy during the chronic stage following onset; even today, surgical therapy for stroke is not universally accepted as appropriate.
Nonetheless, toward the possibility of acute-stage treatment of cerebral stroke, further progress has been made possible by the emergence of magnetic resonance imaging, positron-emission tomography, and digital subtraction angiography, as well as advances in intravascular neurosurgery and the development of brain-protective agents. It has now become possible to save the lives of stroke victims in the acute stage following onset and to obtain favorable functional recovery.