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British researchers have devised a scoring system to predict which patients experiencing probable or definite transient ischemic attacks (TIAs) are at highest risk for stroke within 7 days. The "ABCD score" gives patients higher numbers of points based on age, blood pressure, clinical features of unilateral weakness or speech disturbance without weakness, and duration of symptoms. Points are awarded as follows: age >60 years, blood pressure >140/90 mm Hg, speech disturbance without weakness, and symptoms lasting 10 to 59 minutes each merit 1 point; unilateral weakness and symptoms lasting more than 60 minutes each get 2 points. Only 0.4% of patients with scores lower than 5 experienced a stroke within 7 days, while 31.4% of patients with the maximum score of 6 had a stroke. Based on these results, the investigators suggested that high-risk patients should be counseled to seek immediate medical attention if TIA symptoms appear.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.