Τετάρτη, 15 Μαΐου 2019

Neurology





Imprecise eponyms in stroke medicine – A growing need for uniform terminologies/definitions across the globe
Kamble J Harsha

Neurology India 2019 67(2):364-369

Background: Remarkable advancements in the understanding of etiological risk factors and pathophysiology of cerebrovascular diseases have led to the refining of definitions and terminologies in stroke medicine periodically. We aim to analyze the utility and meaning of different eponyms in the stroke medicine literature during the last 20 years. Materials and Methods: A systematic search was performed in Google Scholar for the words “stroke,” “TIA,” “cerebrovascular accident (CVA),” “cerebrovascular insult,” “cerebrovascular event,” “cerebral ischemia,” and “cerebrovascular disease.” Each of the words were searched yearwise from 1996 to 2015, and the numbers of articles using these words were collected and analyzed. Results: “ Stroke” has been the most common terminology used in literature, which showed a progressive increase in its usage until 2010, after which its use drastically reduced. “Cerebrovascular events” and “cerebral ischemia” are the second most commonly used terminologies with variable definitions; there was a steep increase in the use of these words until 2012. Conclusions: The most imprecise term that continues to be used is “CVA”. The precisely defined entity like “cerebrovascular disease,” which is a group of diseases, continues to be used inappropriately. All the terms are not defined uniformly across the globe, whereas most continue to use the World Health Organisation definition of stroke, defined in the 1970s. It is essential to condemn the use of imprecise terminologies and promote the use of recently defined precise terms “stroke” and “transient ischemic attack (TIA)”. Unless the same terms with precise definitions are used in clinical practice or literature, the progress of stroke medicine will continue to be hampered. 


Should neurosurgeons retire?
Krishnan Ganapathy

Neurology India 2019 67(2):370-374

Being a neurosurgeon is a protracted, time-consuming, and labor-intensive occupation. It presupposes excellent, continuing physical and mental competence, and a passion to always do better than the best. During the last two decades, the exponential deployment of operative technology has resulted in a radical transformation, making a neurosurgeon trained four decades ago, run the risk of being outdated. Expectations from patients have reached an all time high level. Socioeconomic and medicolegal aspects cannot be brushed aside. It is universally accepted that in spite of increasing longevity in the educated upper middle class, the process of ageing per se continues relentlessly. When is enough enough? Is there a risk that a “senior, experienced” neurosurgeon may even become a liability to his patients some day? Should there be a mandatory time point at which a neurosurgeon should necessarily stop operating. The author reviews the published literature and opines that after the age of 65 years, all seniors should agree to their operating privileges being formally reviewed regularly every 2 years. 


Proxy war against head injury: Myriads of conflicting laws and gender-based discrimination
Nishant S Yagnick, Manjul Tripathi, Sandeep Mohindra

Neurology India 2019 67(2):375-376

This article is the culmination of two axioms. The first is the authors' belief that the practice of medicine is, if anything, a social profession. The second is the glaring realization that conscience is the worst motivator. When we combine the two, we understand why a war needs to be waged for a stronger legislation making the wearing of helmets compulsory, and why doctors need to be at the forefront of this war. 


The neurovascular syndromes: A review of pathophysiology – Lessons learnt from Prof. Chandy's paper published in 1989
Harjinder S Bhatoe

Neurology India 2019 67(2):377-388



The infamous story of incident stroke and inflamed gall bladder!
M V Padma Srivastava, VY Vishnu

Neurology India 2019 67(2):389-390



Cholecysto-cardiac link: The heart of the matter
Madhu Nagappa, Arun B Taly

Neurology India 2019 67(2):391-392



Can cognitive decline be the nemesis of motor improvement secondary to deep brain stimulation?
Milind Deogaonkar

Neurology India 2019 67(2):393-394

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