An Improved Scoring System for Identifying Patients at High Early Risk of Stroke and Functional Impairment after an Acute Transient Ischemic Attack or Minor Stroke

Abstract

Risk of recurrent stroke and functional impairment after a TIA or minor stroke can be accurately predicted by a scoring system that utilizes both clinical and MRI information. The ABCD(2)+MRI score is simple and its components are commonly available during the time of admission.

An assessment of the cost-effectiveness of magnetic resonance, including diffusion-weighted imaging, in patients with transient ischaemic attack and minor stroke: a systematic review, meta-analysis and economic evaluation

“…60 When studies looked at the presence/absence of large artery atherosclerosis, which included carotid stenosis as a component, it was found to be a predictor of recurrent stroke at 90 days. 81,134,137,146,147,165,182,[204][205][206][207][208][209] The LSR registered 2940 patients with definite, probable or possible stroke, TIA, AFx or RAO, but 929 were excluded from the present analysis because of severe stroke or only possible cerebral or ocular ischaemic symptoms, leaving 2011 patients for inclusion in the analysis [1093 (54%) minor stroke, 828 (41%) TIA and the remainder had RAO]. Ninety-seven per cent of patients were followed up to 6 months, 90% to 12 months, and 62% to 24 months.…”

“…With respect to the timing of patient assessment after the index event, in 10 studies TIA patients were assessed within 24 hours of symptoms onset, 62,69,87,[134][135][136]138,143,155,161 in six studies within 48 hours, 137,139,141,142,150,165 in one study 140 within 72 hours and in one study 160 within 7 days. Another four studies 9,61,132,144 reported that 'patients were assessed as soon as possible after the event' but did not give a time.…”

“…The ascertainment of stroke events after TIA was carried out by face-to-face patient assessment or telephone interviews in 25 studies, 9,21,24,61,69,81,119,122,128,[132][133][134][137][138][139]144,[149][150][151][152]155,156,161,164,165 by medical records in 15 studies, 23,62,87,120,126,127,129,130,130,135,136,140,143,145,157,159 by mixed methods involving face-to-face assessment plus another method (i.e. telephone interviews, medical records, letters) in 11 studies, 65,131,[146][147][148]153,154,158,…”

“…Four studies assessed population-based cohorts, 132,140,144,151 three studies hospital-based cohorts, 142,155,160 nine studies patients from EDs, 87,134,135,143,149,153,158,162,163 and 10 studies patients from specialist stroke or neurology units. 62,[137][138][139]145,146,150,152,164,177 Full-text papers assessed (n = 61)…”

Ischemic Conditioning Is Safe and Effective for Octo- and Nonagenarians in Stroke Prevention and Treatment

“…The degree of arterial stenosis was based on the MRA or CTA imaging [22,23] and calculated as 1 (the inside diameter of the blood vessel at the point of greatest stenosis/inside diameter of the normal blood vessel at the distal end). Additional inclusion criteria included 1) age 80-95 years; 2) TOAST (Trial of Org 10172 in Acute Stroke Treatment) subtype 1 of stroke (a stroke caused by IAS) [24,25]; 3) National Institutes of Health Stroke Scale (NIHSS) score of 0-15, and modified Rankin Scale (mRS) score of 2-4; 4) ABCD 2 score of 6-7 [20]; 5) stable vital signs, and normal hepatic and renal function; 6) no hemorrhagic tendency.…”