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Optimizing the definitions of stroke, transient ischemic attack, and Infarction for research and application in clinical practice

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dc.contributor.author Abbott, Anne
dc.contributor.author Silvestrini, Mauro
dc.contributor.author Topakian, Raffi
dc.contributor.author Golledge, Jonathan
dc.contributor.author Brunster, Alejandro
dc.contributor.author de Borst, Gert
dc.contributor.author Harbaugh, Robert
dc.contributor.author Doubal, Fergus
dc.contributor.author Rundek, Tatjana
dc.contributor.author Thapar, Ankur
dc.contributor.author Davies, Alun
dc.contributor.author Kam, Anthony
dc.contributor.author Wardlaw, Joanna
dc.date.accessioned 2018-01-11T18:23:48Z
dc.date.available 2018-01-11T18:23:48Z
dc.date.issued 2017
dc.identifier.citation Front Neurol. 2017; 8: 537 es_CL
dc.identifier.uri http://dx.doi.org/10.3389/fneur.2017.00537 es_CL
dc.identifier.uri http://hdl.handle.net/11447/1889
dc.description.abstract Background and purpose Until now, stroke and transient ischemic attack (TIA) have been clinically based terms which describe the presence and duration of characteristic neurological deficits attributable to intrinsic disorders of particular arteries supplying the brain, retina, or (sometimes) the spinal cord. Further, infarction has been pathologically defined as death of neural tissue due to reduced blood supply. Recently, it has been proposed we shift to definitions of stroke and TIA determined by neuroimaging results alone and that neuroimaging findings be equated with infarction. Methods We examined the scientific validity and clinical implications of these proposals using the existing published literature and our own experience in research and clinical practice. Results We found that the proposals to change to imaging-dominant definitions, as published, are ambiguous and inconsistent. Therefore, they cannot provide the standardization required in research or its application in clinical practice. Further, we found that the proposals are scientifically incorrect because neuroimaging findings do not always correlate with the clinical status or the presence of infarction. In addition, we found that attempts to use the proposals are disrupting research, are otherwise clinically unhelpful and do not solve the problems they were proposed to solve. Conclusion We advise that the proposals must not be accepted. In particular, we explain why the clinical focus of the definitions of stroke and TIA should be retained with continued sub-classification of these syndromes depending neuroimaging results (with or without other information) and that infarction should remain a pathological term. We outline ways the established clinically based definitions of stroke and TIA, and use of them, may be improved to encourage better patient outcomes in the modern era. es_CL
dc.format.extent 14 es_CL
dc.language.iso en_US es_CL
dc.publisher Frontiers Research Foundation es_CL
dc.subject stroke es_CL
dc.subject transient ischaemic attack es_CL
dc.subject infarction es_CL
dc.subject asymptomatic carotid stenosis es_CL
dc.subject public health practice es_CL
dc.title Optimizing the definitions of stroke, transient ischemic attack, and Infarction for research and application in clinical practice es_CL
dc.type Artículo es_CL


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