Pathology-based brain arterial disease phenotypes and their radiographic correlates
Jose Gutierrez1, Daniel Bos2, Tanya N Turan3
1Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168th Street, 6th floor, Suite 639, New York, NY 10032, United States.
Summary
Harmonizing terminology for brain arterial diseases like atherosclerosis is vital. This review clarifies pathological and imaging phenotypes for better research and clinical practice in cerebrovascular conditions.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Brain arterial diseases, including atherosclerosis, vasculitis, and dissections, contribute significantly to global cerebrovascular morbidity and mortality.
- These conditions are linked to increased stroke risk, neurodegeneration, and dementia.
- Precise terminology and classification of brain arterial disease phenotypes are essential for advancing research and clinical care.
Purpose of the Study:
- To review and standardize terminology for brain large and small arterial phenotypes.
- To correlate pathological findings with imaging phenotypes used in medical research and clinical practice.
Main Methods:
- Literature review focusing on pathology studies of brain arteries.
- Analysis of imaging phenotypes for intracranial arteries and small vessel disease.
- Harmonization of terminology based on pathological and imaging evidence.
Main Results:
- Arteriosclerosis is an imprecise term; specific etiologies like atherosclerosis or fibroplasia are preferred.
- Atherosclerosis is pathologically defined by atheroma; other pathologies require distinct terminology due to therapeutic implications.
- High-resolution imaging can improve pathological identification of intracranial arterial disease.
- Arteriolosclerosis is often used for small vessel disease, but lipohyalinosis is less accurate; objective measures of small vessel wall characteristics are needed.
Conclusions:
- Standardized terminology for brain arterial disease phenotypes is crucial for accurate diagnosis and treatment.
- Distinguishing between different arterial pathologies, especially atherosclerosis, is vital for clinical management.
- Advanced imaging techniques and objective measures are key to understanding small vessel disease.
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