There are currently no proven treatments for cerebral infarction or intracerebral haematoma. Drug testing is at an exciting phase, however, and thrombolytic and neuroprotective agents appear to have the potential to rescue ischaemic cerebral tissue. The heterogeneous nature of stroke demands adequate patient assessment by clinical and radiological study, with standardised approaches to the measurement of recovery. 2. Previous studies have not fulfilled these stringent criteria, impairing interpretation and inter-study comparison. The needs of drug studies in the acute phase following stroke are discussed in this review.