Medical terminology stroke
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Medical Terminology in Stroke: An Evolving Landscape
Introduction to Stroke Terminology
The term "stroke" has been used for centuries to describe a sudden impairment of cerebral functions, leading to various neurological deficits. Despite its long history, the definition and terminology surrounding stroke have evolved significantly, reflecting advancements in medical science and technology .
Updated Definition of Stroke
The American Heart Association/American Stroke Association has provided an updated definition of stroke to incorporate modern clinical and technological advancements. Stroke is now defined as central nervous system infarction, which includes brain, spinal cord, or retinal cell death due to ischemia, confirmed by neuropathological, neuroimaging, or clinical evidence of permanent injury. This definition encompasses both ischemic strokes, which present with overt symptoms, and silent infarctions, which do not cause known symptoms. Additionally, stroke includes intracerebral hemorrhage and subarachnoid hemorrhage.
Historical Perspectives and Evolving Terminology
Historically, the term "stroke" was coined by Hippocrates around 2400 years ago. Over time, various terms such as "cerebrovascular accident (CVA)," "cerebrovascular insult," and "cerebrovascular event" have been used interchangeably with stroke. However, these terms often lack precision and can be misleading. Modern medical literature emphasizes the need for uniform and precise terminology to improve the clarity and effectiveness of stroke diagnosis and treatment .
Clinical Features and Risk Factors
Stroke is a clinically defined syndrome characterized by acute, focal neurological deficits due to vascular injury, either through infarction or hemorrhage. It is the second leading cause of death and disability worldwide. The majority of strokes (85%) are ischemic, caused by factors such as small vessel arteriolosclerosis, cardioembolism, and large artery athero-thromboembolism. Hemorrhagic strokes, accounting for about 15% of cases, can result from deep perforator arteriopathy, cerebral amyloid angiopathy, or macrovascular lesions .
Stroke in Children
While stroke is predominantly associated with adults, it can also occur in children, albeit less frequently. Pediatric strokes can result from arterial ischemic stroke (AIS), sinovenous thrombosis (SVT), or hemorrhagic stroke. The etiologies in children are often multifactorial, including congenital heart disease, metabolic disorders, and vasospastic conditions like migraines. The treatment focuses on stabilizing systemic factors and managing underlying causes, with increasing use of anticoagulant therapy in pediatric AIS.
The Need for Comprehensive Stroke Care
The traditional view of stroke as a "brain attack" has led to an emphasis on vascular care and primary prevention strategies. However, this approach often overlooks the importance of rehabilitation in stroke recovery. A more balanced approach that includes both acute management and long-term rehabilitation is necessary to address the comprehensive needs of stroke patients.
Conclusion
The terminology and definitions related to stroke have evolved significantly, reflecting advancements in medical understanding and technology. A precise and uniform terminology is crucial for effective diagnosis, treatment, and research in stroke medicine. Additionally, a comprehensive approach to stroke care that includes both vascular management and rehabilitation is essential for improving patient outcomes.
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