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March 21, 1977

Let's Do Away With CVA

JAMA. 1977;237(12):1201. doi:10.1001/jama.1977.03270390017016

To the Editor.—  I read the suggestion of Dr Lester Adelson, "Let's Do Away with CVA" (236:2390, 1976). I am in full agreement that the actual semantics of the terminology is indeed bad: the anatomical lesion should be described in the nomenclature.However, worse than the semantics of the problem is the medical implication. This usually is an "end-all" to further diagnostic procedures and therapy. It has been pointed out in several publications that the terms "stroke" or "CVA" are cover-ups for lesions that are amenable to current techniques of surgical therapy. In a random review of 276 hospital admissions, 46% of patients with this initial diagnosis were found to have surgical lesions.1I think this needs to be pointed out again and again so that cases of patients with abrupt onset of neurologic deficit will be investigated thoroughly and managed adequately.