ADD-ONS / SCALES

ABCD2 score

Created 23/03/2021, last revision 22/09/2022

  • transient ischemic attack (TIA) is a medical emergency defined as a brief episode of neurologic dysfunction due to focal brain, spinal cord, or retinal ischemia, without acute infarction or tissue injury (negative imaging)
  • TIA requires swift evaluation and therapy to decrease the risk of subsequent stroke (about 1 in 3 people with TIA will eventually have a stroke)
  • the ABCD2 score is a simple clinical prediction tool helping to stratify patients presenting with a TIA according to their stroke risk
  • 4 points ⇒ high risk of stroke; hospitalization is recommended (2-day stroke risk is > 4%, 7-day stroke risk: 5.9%!)
  • always use this score together with clinical judgment and brain and vessel imaging findings!
ABCD2 score
(max. 7 points, high stroke risk ≥ 4 )
A Age ≥ 60 years
1
BP ≥ 140/90 mmHg (either SBP ≥ 140 or DBP ≥ 90)
1
C Clinical features of the TIA
Unilateral weakness
Speech disturbance without weakness
2
1
D Duration of symptoms
<10 minutes
10-59 minutes
≥ 60 minutes
0
1
2
D History of diabetes
1
0-3
low risk
2-Day Stroke Risk: 1.0%
7-Day Stroke Risk: 1.2%
90-Day Stroke Risk: 3.1%
outpatient management
4-5
medium risk
2-Day Stroke Risk: 4.1%
7-Day Stroke Risk: 5.9%
90-Day Stroke Risk: 9.8%
hospitalization rather recommended
6-7
high risk
2-Day Stroke Risk: 8.1%
7-Day Stroke Risk: 11.7%
90-Day Stroke Risk: 17.8%
hospitalization recommended
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