For decades the occurrence of an insult to the brain from ischaemia or from haemorrhage was used to localize brain function or to describe syndromes. It was an academic pursuit and of little help to the patients. Prevention and therapy remained elusive. Fortunately, revolutionary changes followed upon several sequential and contemporaneous developments: imaging of the blood vessels, the brain and the heart; explosive new knowledge about thrombosis and strategies to modify it; surgical techniques to remove the lesions of arterial degenerations and faults; and the maturation of the science of epidemiology, methodology and biostatics which lead us on a path towards the practice of evidence-based medicine. This work aims to assist practitioners to make practical use of this rapidly expanding body of knowledge. It is written to assist those at the bedside or the clinic, in sorting out what is useful, to point out what is likely to become useful, and to caution about therapeutic strategies which remain in the realm of speculation. The book is a distillation of that which currently is useful to know and utilize in the field of cerebral vascular disease.