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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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sábado, 30 de mayo de 2015

Ictus y AIT

emDocs

emDocs - May 29, 2015 - By Ferguson W, Crane D, Lo A
Edited by Koyfman A and Alerhand S

"ED management of the person with TIA
  • All TIA patients should undergo risk stratification using the ABCD2 score (not great tool but current go-to):
  • Age > 60 years (1 point)
  • Blood Pressure > 140/90 mm Hg (1 point)
  • Clinical Symptoms
    • Unilateral focal weakness (2 points)
    • Speech impairment without weakness (1 point)
    • Other symptoms (0 point)
  • Duration
    • 60 minutes (2 points)
    • 10 to 59 minutes (1 point)
    • <10 minutes (0 point)
  • History of Diabetes (1 point)
  • The ABCD2 score provides a validated 2-day risk of stroke:
    • Score of 0 or 1: Risk of stroke <1%
    • Score of 2 or 3: Risk of stroke 1.3%
    • Score of 4 or 5: Risk of stroke 4.1%
    • Score of 6 or 7 (9): Risk of stroke 8.1%
  • AHA/ASA recommends hospitalization for score > 2 (6)
  • The TIA work-up as recommended by the American Heart Association and American Stroke Association includes (6)
    • Neuroimaging evaluation within 24 hours of symptom onset, preferably MRI with diffusion weighted imaging
    • Noninvasive imaging (US, MRA, CTA) of the cervical vessels and optional recommended noninvasive imaging of intracranial vessels
    • Electrocardiography and cardiac monitoring
    • Routine blood tests"
http://www.emdocs.net/stroke-and-tia-pearls-and-pitfalls/