Predictable risk of cerebral infarction following a transient ischaemic attack
Koudstaal, P.J.
Nederlands Tijdschrift Voor Geneeskunde 149(30): 1661-1663
2005
ISSN/ISBN: 0028-2162 PMID: 16104109 Document Number: 589304
To date most studies that have addressed prognostic factors in patients who have had a transient ischaemic attack (TIA) have determined the risk of cerebral infarction during the first 3 years following TIA. Two recent studies have investigated the very long-term and very short-term risks. The long-term study found that the risk unexpectedly increased after 3 years. The short-term study found the very early risk of cerebral infarct (< 7 days) to be substantial at 10%. The proposed ABCD score enables the physician to easily identify patients at particularly high risk: (A) 1 point for age > or =6o years, (B) 1 for systolic blood pressure >140 mmHg and/or diastolic pressure >90 mmHg, (C) 2 points for unilateral weakness, 1 for speech disturbance without weakness, (D) 2 points for an attack lasting > or =1 h and 1 point for an attack lasting 10-59 min. A patient with a total score of 5 has a risk of 12.1% of developing a cerebral infarct within 7 days. In a patient with a score of 6 this risk is 31.4%.