Experts welcome stroke classification as neurological disease

The medical rationale for stroke being a neurological condition has always been compelling. We therefore welcome the latest decision by the Department of Statistics at the WHO to move the thematic block of cerebrovascular diseases from the circulatory diseases chapter to diseases of the nervous system," noted Prof Raad Shakir, head of the WHO Neurology Topic Advisory Group and President of the World Federation of Neurology (WFN).

Public support for the latest WHO move on the issue of stroke classification follows a period of expert discussions and major concern in the neurological community. Last October, leading international neurology and stroke specialists publicly expressed their concern in an editorial in The Lancet about the classification of stroke in the draft revision of the "International Statistical Classification of Diseases and Related Health Problems" (ICD). This step was in response to an unexpected change in the classification system by which the newly created group of cerebrovascular diseases was moved from neurological to circulatory diseases.

The ICD-10 currently in place is based on outdated medical knowledge and concepts from the 1950s. The new ICD-11, which has been under discussion since 2009, is aimed at reflecting the changes in science and practice and is slated for release in 2018. Although it has taken 62 years to make the change, it is now a reality and a benefit to patients, treating doctors and researchers, and the public at large.

Prof Shakir: "There are very good reasons why the WHO Neurology Topic Advisory Group advocated all throughout this process that all types of stroke should form a single block in the new classification and be part of the nervous system disease chapter. All manifestations of cerebrovascular disease are related to brain dysfunction. We are relieved and fully support the prudent and farsighted changes implemented by the WHO team."

According to the WFN President the latest classification decision with respect to stroke serves the interests of patients' needs. Prof Shakir: "It also ensures that health care provision and funding will be based on correct figures, which has not been the case thus far."