risk factors for ischemic stroke after TIA
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Notes
- TIA > 30 minutes in duration
- disturbance in higher brain function as part of presentation (i.e. aphasia)
- diffusion-weighted magnetic resonance imaging abnormalities[5]
- a 7 point* ABCD2 score predicts short-term risk of stroke after TIA[2]
- age > 60 (1)
- blood pressure on presentation
- clinical features
- unilateral weakness (2)
- speech disturbance without weakness (1)
- duration of symptoms
- > 60 minutes (2)
- 10-59 minutes (1)
- < 10 minutes (0)
- diabetes mellitus (1)
* points in parentheses
- multiple infarctions on brain imaging, large-artery atherosclerosis, & an ABCD2 score of 6 or 7 each associated with > 2-fold increase risk of stroke[6]
- this in context of urgent care & management by stroke specialists that half risk of ischemic stroke[6]
- risk of CV event including stroke after TIA = 6.4% in 1st year & 6.4% in 2nd-5th years[7]
More general terms
References
- ↑ Journal Watch 24(7):54, 2004 Inatomi Y et al, Neurology 62:376, 2004 Warach S & Kidwell CS, Neurology 62:359, 2003
- ↑ 2.0 2.1 Journal Watch 25(17):134, 2005 Rothwell PM, Giles MF, Flossmann E, Lovelock CE, Redgrave JN, Warlow CP, Mehta Z. A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack. Lancet. 2005 Jul 2-8;366(9479):29-36. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15993230
Perry JJ et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ 2011 Jul 12; 183:1137. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21646462 - ↑ Tsivgoulis G et al, Validation of ABCD score in identifying individuals at high early risk of stroke after a transient ischemic attack: A hospital-based case series study. Stroke 2006, 37:2982 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17053179
- ↑ Johnston SC, Rothwell PM, Nguyen-Huynh MN, Giles MF, Elkins JS, Bernstein AL, Sidney S. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet. 2007 Jan 27;369(9558):283-92. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17258668
- ↑ 5.0 5.1 Giles MF et al. Early stroke risk and ABCD2 score performance in tissue- vs time-defined TIA: A multicenter study. Neurology 2011 Sep 27; 77:1222. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21865578
- ↑ 6.0 6.1 6.2 Amarenco P, Lavallee PC, Labreuche J et al One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke. N Engl J Med 2016; 374:1533-1542. April 21, 2016 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27096581
Sacco RL, Rundek T The Value of Urgent Specialized Care for TIA and Minor Stroke. N Engl J Med. 2016 Apr 21;374(16):1577-1579. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27096584 - ↑ 7.0 7.1 Amarenco P, Lavallee PC, Tavares LM et al Five-Year Risk of Stroke after TIA or Minor Ischemic Stroke. N Engl J Med 2018; 378:2182-2190. June 7, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29766771 Free full text https://www.nejm.org/doi/full/10.1056/NEJMoa1802712