Acute cerebrovascular accident (ACV) is a major medical and social problem. The incidence of stroke is 2.5 - 3 cases per 1000 population per year, mortality - 1 case per 1000 population per year. Mortality in the acute period of stroke in Russia reaches 35%, increasing by 12-15% by the end of the first year after a stroke. Post-stroke disability ranks first among all causes of disability and is 3.2 per 10,000 population. 20% of stroke survivors return to work, while one third of those with stroke are people of working age. Thus, in Russia, stroke develops annually in 400-450 thousand people, approximately 200 thousand of them die. More than 1 million stroke survivors live in the country, and 80% of them are disabled. The rest 20% of strokes are hemorrhagic in nature. Ischemic etiologies can further be divided into embolic, thrombotic, and lacunar. In general, the common risk factors for stroke include hypertension, diabetes, smoking, obesity, atrial fibrillation, and drug use. Hemorrhagic etiologies can be from hypertension, aneurysm rupture, arteriovenous malformations, venous angiomas, bleeding due to illicit drugs like cocaine, hemorrhagic metastasis, amyloid angiopathy, and other obscure etiologies. Lacunar strokes contribute up about 20% of all ischemic strokes and result from occlusion of the small penetrating branches of the middle cerebral artery, vertebral or basilar artery or the lenticulostriate vessels.