Article Text

Download PDFPDF
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}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

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 …

View Full Text


  • Contributors Author contributed to drafting and final approval of manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.