Use of neuroimaging in acute stroke trials

In the last few years, the development of reperfusion techniques in the treatment of acute ischemic stroke has transformed the concept of a noncurable, nonurgent illness to one of the most emergent no-time-to-waste diseases. However, this time dependence hampers the spreading of treatment to a wider patient population. The new neuroimaging techniques for acute stroke aim to increase the number of eligible patients by extending the window through tissue viability rather than time, and to better select those who will safely benefit from thrombolysis in this extended time window. This article summarizes the neuroimaging techniques available currently and describes the new developments in acute stroke treatment trials.