Imaging maintains a critical and growing role in the care of stroke patients, broadly spanning diagnosis, prognostication, therapy selection, and treatment monitoring. Current radiological approaches to the evaluation of neur-ovascular disease comprise primarily 2 modalit-ies—computed tomography (CT) and magnetic resonance imaging (MRI)—each a seminal technological advancement in biomedicine with ever-expanding potential as noninvasive or minimally invasive probes of brain perfusion, metabolism, and tissue viability.
While stroke remains a widely used, but imprecise term, describing an acute clinical scenario, this review will focus principally on the imaging of acute ischemic brain infarction. A standardized approach to imaging selection and interpretation will be emphasized, underscoring (1) modality selection; (2) technical elements of CT and MRI approaches to neurovascular imaging; (3) the staging of brain ischemia; and (4) advanced brain imaging for prognostication and treatment selection in acute stroke patients. Where possible, relevant patient-specific factors and hardware demands will be discussed, with the objective of facilitating communication and optimizing imaging utilization in such patients.