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    ABCD² Score for TIA

    Estimates the risk of stroke after a after a suspected transient ischemic attack (TIA).
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    Management

    Consider further imaging modalities including MRI and carotid ultrasound.

    Consider consulting Neurology to help determine whether the patient would benefit from further inpatient evaluation or to expedite outpatient follow-up when appropriate.

    In patients who are determined at high risk for developing a stroke:

    • Consult Neurology.
    • Consider obtaining an MRI and other appropriate vascular and embolic imaging.
    • Have a lower threshold to admit to the patient for further evaluation.

    In patients who are determined to be at low risk of developing a stroke in the short term:

    • Arrange expedited evaluation as an outpatient with the goal of obtaining the relevant studies and consultations within 24 hours.

    Critical Actions

    • The ABCD2 score should not be used as a substitute for clinical judgement or decision making.
    • In populations with a low baseline stroke risk, a low ABCD2 score (0-2) correlates with a less than 1% risk of stroke within the next week. These patients may be appropriate for expedited outpatient evaluation.
    • In centers where computed tomography and carotid ultrasound studies are performed in collaboration with a stroke service, adding the ABCD2 score to the evaluation appears unnecessary.
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