Elsevier

The Lancet

Volume 388, Issue 10059, 19–25 November 2016, Pages 2475-2476
The Lancet

Correspondence
Revising the ICD: stroke is a brain disease

https://doi.org/10.1016/S0140-6736(16)31850-5Get rights and content

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    Low-and-middle income countries (LMICs) bear a high global burden of not only neurological but also cardiovascular disorders (Mensah et al., 2015; Silberberg et al., 2015), which until recently used to include stroke. With the recently revised ICD-11 classification (Shakir et al., 2016), stroke is now finally considered a brain disease or a neurological disorder. While there are considerable geographical variations, the prevalence of stroke in a large number of sub-Saharan African countries is reported to be the highest with an estimated overall Africa rate of 981 per 100,000 (Group, 2017; Owolabi et al., 2015b).

  • The need for a Global Neurology Alliance

    2017, Journal of the Neurological Sciences
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    While the grounds for such opposition were reasonable and based on a desire to obtain the best longitudinal epidemiological data, it effectively “hid” the impact of stroke in the global community and paid little heed to the growing evidence of the contribution of cerebrovascular disease to dementia and NCDs in general. There followed initial correspondence to Lancet [10] by the WFN and WSO, and the formation of an ad hoc advisory group from both, the recruitment of national departments of health to voice opposition to the way stroke was handled by the WHO, a number of important face-to-face and telephone meetings as well as a review of the evidence, from the WSO perspective, why stroke should not be classified as only a circulatory disease. Through an innovation introduced in the ICD-11 version, multiple parenting was possible and this together with the weight of argument has seen stroke, as of April 2017, classified as a cerebrovascular disease in the current beta version of ICD-11 – an event described by many as momentous [11].

  • Stroke is a brain disease

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  • Assessing the outcome of stroke in Australia

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