Vascular

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Abstract
Cerebrovascular neurosurgery is a field where the highs are high and the lows are low. The successful cerebrovascular neurosurgeon gets to save lives and restore neurological function but must also to attend families and patients who are facing stroke and death. Patients generally fall into 2 categories: those who have had hemorrhagic or ischemic strokes, and those who are at risk for stroke but are so far unscathed. Patients in the first group have experienced a catastrophe. The neurosurgeon typically meets the patient and their family in the hospital. Morbidity and mortality within this group is common and can be devastating. The able neurosurgeon must be able to assess the situation and act rapidly to prevent worsening of neurological damage and decide how best to keep the patient from further harm. Those in the second group have often received a diagnosis after medical imaging for an unrelated complaint. While the vascular lesion may be asymptomatic, these patients are fearful and anxious about the possibility of experiencing a stroke. For these patients, neurosurgeons must be able to summarize the available evidence, provide comfort, and recommend the safest treatment option. Sometimes the safest course is not surgery, but instead, reassurance and medical management.

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