**7. Conclusion**

Stroke is a medical entity that was known in ancient Greece as apoplexy. Hippocrates was the first to describe a patient with stroke like symptoms followed by Areteus and Galen. Ischemic stroke was once a disease process of which we had a scarce understanding. Efficient treatments were, however, made possible with more insight into the anatomical and pathophysiological changes that are associated with ischemic stroke. These developments were attributed to Wepfer, Virchow, Murphy, Cooley and others. The advancement in technology, such as the development of cerebral angiography, CTA and CTP, were also crucial in the advancements made in treating ischemic stroke.

Neurosurgeons are able to perform a wide range of procedures to manage ischemic stroke and thus their role in this disease remains pivotal. For prevention of stroke, CEAs are performed; for reperfusion of salvageable brain tissue, mechanical thrombectomies improve outcomes; and for management of brain herniation hemicraniectomies are carried out. Additionally, endovascular mechanical thrombectomies have undoubtedly revolutionized the way ischemic stroke is managed. But, more progress remains to be made, with several previous and on-going randomized controlled studies attempting to find the gold standard for treating ischemic stroke.

Ischemic stroke remains a major public health concern that can undoubtedly cause severe disability. Even with increase efforts for public education and primary prevention, neurosurgeons still need to be able to manage ischemic strokes efficiently.
