A considerable amount of literature exists regarding the importance of carotid artery disease in the production of cerebral ischemia, with much less attention being focused on arterial occlusive disease of the vertebral arteries. The reasons for these discrepancies are probably related to the seemingly vague symptoms associated with vertebrobasilar insufficiency (VBI), the lack of noninvasive evaluative methods, and the difficulty in revascularizing distal vertebral artery occlusions. A more important question, however, is whether the identification and surgical treatment of these lesions improve symptoms and stroke-free survival. This book answers many of these questions and gives a timely update of current diagnostic and surgical modalities for the treatment of VBI. The book consists of 27 reports presented at the first International Conference on Vertebrobasilar Occlusive Vascular Disease in 1982. The reports vary greatly in quality, although the surgical input is outstanding with good illustrations, narrative descriptions, and operative results. However, the