The postoperative functional results presented in the case reports of this monograph seem to favor early microsurgical therapy of compressive lesions at the optic canal before optic atrophy has occurred. The precondition for timely surgical intervention, however, is an early diagnosis made jointly by the clinician and the radiologist. Both must be familiar with the signs pointing to optic nerve compression: the former with the clinical symptoms, the latter with the computed tomographic signs. Some of the disease entities responsible for optic nerve compression are ill-known to both. This applies particularly to pneumosinus dilatans and dolichoectatic vascular changes, the true incidence and natural course of which remain unclear. Familiarity with these lesions and appropriate CT examination techniques may in the future enable better estimation and optimal treatment of these conditions based on a larger sample of patients. Before such data are available, the indication for decompressive surgery should mainly be limited to those patients who show both the clinical signs and radiological findings that lead one to suspect optic nerve compression. Decompressive surgery should preferably be performed by experienced neurosurgical microsurgeons.