Background: Traditionally, non-contrast computed tomography (CT) alone was used in the initial assessment of acute ischaemic stroke patients mainly to exclude haemorrhage or alternative pathology. Summary: Late-window (beyond 6 h) and recent large-volume endovascular mechanical thrombectomy (MT) trials integrated CT perfusion (CTP) imaging to guide MT and/or intravenous thrombolysis decision-making in stroke patients. Key Messages: In current clinical practice, many patients are being excluded from reperfusion therapy due to a lack of data from urgent investigations to assess cerebral vasculature and perfusion. Here, we explore the potential benefits of CTP incorporated into the initial CT protocol assessment of stroke patients.

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