Current State of Acute Stroke Imaging

Acute ischemic stroke is common and often treatable. Imaging by computed tomography (CT) and MRI is valuable for stroke treatment, in addition, for diagnosis, and for identification of the pathogenesis. But how they are used also depends on practical considerations. The approach to imaging the patient with acute stroke used at the Massachusetts General Hospital (MGH) is described. It is a distillation of our experience and a critical review of the literature and was developed through collaborations among the Acute Stroke Service, the Neuroradiology Division, and the Neurointerventional Program at the MGH. The focus is on rapid diagnosis, the guidance of treatment using intravenously administered tissue-type plasminogen activator (tPA), and intra-arterial treatments (IATs).