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Controversial topics are meant to elicit strong but divergent opinions and the current edition of Point-Counterpoint continues to focus passionate debate on the challenges facing current neurointerventional practice. The imaging guidance of acute ischemic stroke treatment has been evolving both mathematically and conceptually alongside the progress in endovascular stroke treatment thanks to the sustained and dedicated research and leadership in the field of neuroradiology by Drs Wintermark and González. Over the years the volume of material regarding brain perfusion imaging and the various ways it can be obtained and determined has certainly proved …