Summer 2009

Prevention Angle: Stratifying Post-TIA Risk

"We consider TIA (transient ischemic attack) an emergency because numerous studies have shown that the risk of stroke after TIA is 10 to 15 percent in the ensuing 90 days, with half of those strokes occurring in the first two days," says S. Claiborne Johnston, M.D., director of the UCSF Neurovascular Disease and Stroke Center.

Johnston's own research efforts were instrumental in the development of the ABCD2

"Especially when paired with advanced imaging, these scores can help save lives. If the clot is in a large artery — and if you have a team available — you can fix the problem with medical or surgical techniques," says Smith. Though it's not yet firmly established that stratification and aggressive treatment of the most at-risk TIA patients prevent stroke, Smith believes that "this can be the Holy Grail because it can save lives and be cost-effective."

ABCD2
Age ≥60  1 point
Blood pressure ≥140/90mmHg  1 point
Clinical Symptoms
Unilateral weakness
Speech impairment without weakness

 2 points
 1 point
Duration
≥60 minutes
10–59 minutes

 2 points
 1 point
Diabetes  1 point
Total Score 0–7

For more information, contact S. Claiborne Johnston, M.D. at (415) 476–2477.

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