Neuroimaging in stroke

Jason W Tarpley MD PhD (Dr. Tarpley of the University of California, Los Angeles, has no relevant financial relationships to disclose.)
George P Teitelbaum MD (Dr. Teitelbaum of Providence Southern California received consulting fees from Medronic.)
David S Liebeskind MD (Dr. Liebeskind of the University of California, Los Angeles, received consultation fees from Stryker and Medtronic.)
Steven R Levine MD, editor. (

Dr. Levine of the SUNY Health Science Center at Brooklyn has no relevant financial relationships to disclose.

Originally released November 4, 2013; last updated July 9, 2018; expires July 9, 2021


The diagnosis of acute ischemic stroke and conditions that mimic its clinical presentation has become increasingly dependent on neuroimaging findings. Additionally, neuroimaging directly guides treatment of acute stroke patients by identifying appropriate candidates for acute therapies and informing the workup of stroke etiology. The authors provide an article on the use of neuroimaging in the diagnosis and management of the acute ischemic stroke patient.

Key points


• When performing neuroimaging evaluation of acute stroke and transient ischemic attack patients, there are several appropriate imaging strategies.


• Consistency of the imaging strategy within a given institution is important to facilitate reliable technical execution, rapid evaluation, and accurate interpretation of results.


• The primary goal of acute imaging in ischemic stroke is to identify candidates for powerful and effective therapies including intravenous thrombolysis and endovascular revascularization.


• A second but fundamental goal of stroke imaging is to inform the diagnostic workup for stroke mechanism, treatment, and secondary prevention. Adequate expertise in vascular neurology with understanding of cerebrovascular anatomy and pathology and their manifestation on imaging should form the basis of this workup.


• Current stroke workflow has inefficiencies, especially in evaluating advanced imaging.

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