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ABCD² Score for TIA

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

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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