Abstract
Recently it has been proved that carotid endarterectomy (CEA) is effective for the prevention of major stroke for the patients with symptomatic severe carotid stenotic lesion. However, the efficacy of extracranial-intracranial arterial bypass (EC-IC bypass surgery) for the patients with cerebrovascular occlusive lesion is still controversial. Several cooperative trials to clarify the surgical efficacy of stroke prevention and improvement of brain function had been unsuccessfully attempted. Despite this situation, a considerable number of neurosurgeons still believe bypass surgery should play some role in the treatment of cerebral ischemia.In this paper, we review the pathophysiology of cerebral ischemia, and discuss how to surgically treat it.
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