The author presents contemporary views on the main pathophysiological mechanisms of focal cerebral ischaemia and gives an account of possibilities of pharmacological treatment. Consistent with the concept of so-called pharmacological window he divides treatment of acute cerebrovascular ischaemia into treatment of the acute stage (within eight hours after the development of the attack) and treatment of the subacute and chronic stage. He emphasizes the basic importance of early hospital admission to special intensive care units (stroke units) to improve the resulting therapeutic effect and to reduce mortality. He draws attention to the debt of the Czech health services in this sphere of care and treatment of cerebrovascular attacks.