Citation: Aziz W (2014) Evolution of Neuro-Endovascular Surgery from Serendipity and Sagacity to Evidence Based Medicine, History and Future Directions. J Neurol Stroke 1(1): 00001. DOI: 10.15406/jnsk.2014.01.00001 The most common disorders affecting the cerebral circulation are strokes. Stroke is one of the leading causes of permanent disability, and is the third largest cause of death in western countries. Annually, more than 700,000 individuals in the United States experience new or recurrent strokes . If this number is correlated to the size of the international population, the predicted number worldwide will yield a huge sum of cases, with its huge burden on the health care systems, families, and the whole economy.