Abstract
Precision
cerebrovascular health or individualized long-term preservation of the
brain and associated blood vessels, is predicated on understanding,
diagnosing, and tailoring therapies for people at risk of ischemic
injury associated with stroke and vascular dementia. The associated
imaging patterns are sculpted by the protective effect of the
collaterome, the innate compensatory ability of the brain and
vasculature to offset hypoperfusion when antegrade or normal arterial
inflow pathways are compromised. Theranostics or rational and
synchronous use of diagnostic studies in tandem with specific therapies
to optimally guide patient outcomes in ischemic brain disorders may
capitalize on the pivotal role of the collaterome. Understanding the
functional impact of the collaterome across populations of individuals
would advance translational science on the brain, while questions with
immediate clinical implications may be prioritized. Big data and
systematic analyses are necessary to develop normative standards,
multimodal imaging atlases, and delineation of specific patterns to
guide clinical management. Large-scale, systematic imaging analyses of
the collaterome provide a platform for translational work on cerebral
collateral circulation and hemodynamics and a theranostic framework with
direct clinical implications. This article frames incipient research
objectives to guide precision stroke medicine in coming years, building
upon the collaterome concept in brain health.
No comments:
Post a Comment