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Introduction Angiogenesis and neuroplasticity are biologically based mechanism that mediate stroke recovery and are critical in restoring cerebral perfusion and restructuring neural pathways after injury. Current technology in neuroimaging, such as perfusion-weighted imaging (PWI), diffusion tensor imaging (DTI), functional MRI (fMRI), and transcranial Doppler (TCD), can be used to determine these restorative processes in vivo. However, it is not yet well understood to what degree traumatic brain injury (TBI) alters such regenerative pathways. Material and Methods A comprehensive literature search was conducted in PubMed, Scopus, and ScienceDirect, including both clinical and preclinical studies published between 1999 and 2024. Search terms included “stroke,” “neuroplasticity,” “angiogenesis,” “traumatic brain injury,” “MRI,” “DTI,” “fMRI,” “PWI,” and “cerebral perfusion.” The studies were given priorities based on the inclusion of neuroimaging information pertinent to cerebral repair mechanisms post-stroke. Results The reviewed literature suggests that imaging markers of cerebral perfusion, white matter integrity, and functional connectivity are reliable measures of angiogenic and neuroplastic recovery following stroke. Patients with a history of TBI are often characterized by delayed or modified recovery patterns, which can be probably explained by chronic vascular impairment and impaired plastic capacity. Neuroimaging integration in post-stroke evaluation procedures aims to early detect unfavorable cases and develop more personalized rehabilitation plans. Conclusions Neuroimaging is a powerful stroke recovery assessment modality. The need to identify risks with accuracy and provide a specific line of treatment amplifies its utility among patients with antecedent TBI. The entire dynamics between pre-existing brain injury and post-stroke repair mechanism is invaluable in promoting improved clinical outcomes. |