Imaging in acute stroke--a personal view.

Acute stroke imaging has developed from intraarterial angiography and native, unenhanced CT to highly elaborated tools with the access to a variety of pathophysiological variables ahead of therapy. Despite enduring unresolved problems, we can now obtain a comprehensive view on the individual patient's disease and act fast and specifically under consideration of chances and risks of different therapies. The stroke neuroradiologist is the decisive partner of engaged clinical disciplines and should own a leading role in future acute stroke trials. Weighing the different modalities against each other, there is an established advantage of acute stroke MRI over CT based on diffusion-weighted imaging and the possibility to obtain even more functional information on stroke pathophysiology.