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.
- 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.