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Although new imaging techniques such as MR perfusion/diffusion and xenon CT have shown considerable promise in the detection of early brain ischemia, noncontrast CT remains the primary imaging test for the evaluation of acute stroke. It is fast, reliable, readily available, and continues to be used for all major stroke therapy trials. Despite its limitations, CT is an accurate method of screening patients prior to thrombolytic therapy.

Cerebrovascular trauma is a heterogeneous group of injuries including arterial dissections, traumatic aneurysms, arteriovenous fistulas, and venous occlusions. Detection of vascular trauma may be difficult because of variations in clinical presentation; however, in recent years, increased awareness and understanding of these injuries has improved the ability to detect and subsequently treat many lesions. Despite advances in other imaging modalities, angiography remains the primary radiographic tool used in the evaluation of traumatic vascular lesions.