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September 5, 1977

Anatomical Diagnosis of Stroke

Author Affiliations

Kern Medical Center Bakersfield, Calif

JAMA. 1977;238(10):1025. doi:10.1001/jama.1977.03280110029009

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To the Editor.—  The discussion (237:2036, 1977) of the semantics of "CVA" and "stroke" by Posner and Fink are indeed enlightening and entertaining. My interest is not with the terminology or usage but with implications thereof. The stroke or CVA patient may be assigned to the lowest-ranking house officer on the service, placed at the most distant corridor of the ward, and treated with wholesome neglect. The connotation is one of hopelessness and despair.This is not in keeping with current and advancing technology in the management of cerebrovascular disease. Delineation of a specific lesion is much more than a literary nicety and an improvement in communication.Precise anatomical diagnosis is the sine qua non for successful treatment; the following are a few examples of the relationship between an accurate determination of the pathological process and therapy. Carotid artery bifurcation plaque causing transient ischemic attacks (TIAs) is frequently amenable to