Neuroimaging of Stroke: A Review
Advances in neuroimaging technology during the past 30 years have resulted in a virtual explosion in the amount of pathologic information that can be obtained in the clinical stroke setting. This neuroimaging revolution has led to a much better understanding of cerebrovascular and tissue pathology, creating a wide array of opportunities for acute treatment and secondary prevention. Advances include early and accurate detection of ischemic and infarcted tissue and the ability to reveal hypoperfused tissue at risk. Clinicians are increasingly able to noninvasively detect embolic and atherothrombotic intravascular lesions. Vascular lesions associated with stroke can be characterized through endovascular neuroimaging techniques and repaired by various means. In this article, we provide an overview and update on the various techniques used in the neuroimaging of stroke and intracranial hemorrhage, including computed tomography, magnetic resonance imaging, ultrasound, and catheter angiography. We outline the specific role of each modality in clinical practice.

Stroke is a leading cause of death and disability worldwide. Three decades ago, the diagnosis of stroke was largely dependent on bedside clinical methods. Our knowledge of the localization and the nature of the underlying pathologic process could only be verified independently postmortem; this seriously hampered initial attempts at developing and implementing appropriate therapeutic interventions. Advances in neuroimaging technology during the past 30 years have resulted in a virtual explosion in the amount of pathologic information that can be obtained in the clinical stroke setting. This neuroimaging revolution has led to a much better understanding of cerebrovascular and tissue pathology, creating a wide array of opportunities for acute treatment and secondary prevention. Advances include early and accurate detection of ischemic and infarcted tissue and also the ability to reveal hypoperfused tissue at risk. Clinicians are increasingly able to noninvasively detect embolic and atherothrombotic intravascular lesions. Through endovascular neuroimaging techniques, vascular lesions associated with stroke can be characterized and repaired by various means. In this article, we provide an overview and update on the various techniques used in the neuroimaging of stroke and intracranial hemorrhage, including computed tomography, magnetic resonance imaging, ultrasound, and catheter angiography. We outline the specific role of each modality in clinical practice.