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Why be an optimist if you treat stroke?
  1. Lucas Elijovich
  1. Correspondence to Dr Lucas Elijovich, Semmes-Murphey Clinic, Department of Neurology and Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee 38120, USA; lelijovich{at}semmes-murphey.com

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I was recently surprised by a patient’s daughter who I bumped into in the hallway. I had just stepped out of the angiography suite after a long embolization of a complex ruptured dural arteriovenous fistula. I don’t usually have conversations in front of the elevator, but she was understandably anxious to hear the results of her mother’s procedure. I quickly found out that she was a family medicine nurse practitioner, we had been in practice about the same amount of time, and she clearly understood her mother was critically ill. Despite her education and experience, we were not on the same page when it came to her neurologic diagnosis. I explained that her mother had an intracerebral hemorrhage – a stroke from an arteriovenous malformation, specifically a dural arteriovenous fistula. She seemed confused about the use of the word stroke. Didn’t her mother have a ‘blood clot’, that is what the resident had told her. No one had used the words stroke or arteriovenous malformation. By the end of our conversation the daughter was clear that her mother indeed had a stroke. However, I was troubled how …

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