This text provides insights into current trends and controversial issues regarding state-of-the-art techniques in neurosurgery, interventional neuroradiology, and endovascular surgery. The authors confront such questions as: Are unruptured aneurysms managed most effectively by neurosurgical clipping or endovascular coiling? Is surgery or endovascular coiling the best treatment for ruptured cerebral aneurysms of the anterior or posterior cerebral circulation? In managing arteriovenous malformations and fistulas, should clinicians use neurointerventional techniques or surgery, or a combination of both?