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/