Journal Club: early stroke risk and ABCD2 score performance in tissue vs time-defined TIA.
نویسندگان
چکیده
Jennifer E. Fugate, DO Alejandro A. Rabinstein, MD In this journal club article, we evaluate a study by Giles and colleagues1 that reports stroke risk in patients with classically defined TIA subcategorized by presence or absence of radiologic brain infarction. The concept of a TIA is evolving in parallel with better understanding of brain ischemia and insights gained from neuroimaging studies. TIAs were classically defined as a sudden focal neurologic deficit resulting from brain or retinal ischemia lasting less than 24 hours.2,3 The time threshold of 24 hours was arbitrarily chosen, and given that there is no evidence to support any single time criterion associated with infarction, this has appropriately been questioned. A newer and well-received definition of TIA is “a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.”4 This definition communicates the important concept that transient symptoms can nonetheless be associated with permanent brain injury, encourages the use of neuroimaging studies, and may promote rapid interventions for acute brain ischemia. The ABCD2 score, a risk-stratifying score for patients with TIA, is derived from the patient’s age, blood pressure, clinical features, TIA duration, and history of diabetes. This simple, validated score identifies patients at highest risk of early stroke after TIA.5 Scores are commonly divided into low risk (0– 3), intermediate risk (4–5), and high risk.6,7 The clinical ABCD2 scale is integrated in this study with results from acute brain imaging to assess how the new tissue-based definition of TIA further assists with risk stratification of patients with transient neurologic symptoms.
منابع مشابه
Early stroke risk and ABCD2 score performance in tissue- vs time-defined TIA: a multicenter study.
OBJECTIVES Stroke risk immediately after TIA defined by time-based criteria is high, and prognostic scores (ABCD2 and ABCD3-I) have been developed to assist management. The American Stroke Association has proposed changing the criteria for the distinction between TIA and stroke from time-based to tissue-based. Research using these definitions is lacking. In a multicenter observational cohort st...
متن کاملThe ABCD, California, and unified ABCD2 risk scores predicted stroke within 2, 7, and 90 days after TIA.
متن کامل
High ABCD2 Scores and In-Hospital Interventions following Transient Ischemic Attack
BACKGROUND AND PURPOSE Following transient ischemic attack (TIA), there is increased risk for ischemic stroke. The American Heart Association recommends admission of patients with ABCD2 scores ≥3 for observation, rapid performance of diagnostic tests, and potential acute intervention. We aimed to determine if there is a relationship between ABCD2 scores, in-hospital ischemic events, and in-hosp...
متن کاملEarly diffusion weighted MRI as a negative predictor for disabling stroke after ABCD2 score risk categorization in transient ischemic attack patients.
BACKGROUND AND PURPOSE The prognostic value early diffusion-weighted magnetic resonance imaging (DWMRI) adds in the setting of transient ischemic attack (TIA), after risk stratification by a clinical score, is unclear. The purpose of this study is to evaluate, after ABCD2 score risk categorization in admitted TIA patients, whether negative DWMRI performed within 24 hours of symptom onset improv...
متن کاملStroke: Highlights of Selected Articles
Copeptin is a stress hormone that has previously been shown to be associated with recurrent cerebrovascular events after transient ischemic attack (TIA). The ABCD2 (age, blood pressure, clinical features, duration, diabetes) score and the ABCD3-I (ABCD2 plus dual TIA) score both provide risk assessment for recurrent stroke after TIA. The current study aimed to determine the effect of copeptin i...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Neurology
دوره 78 12 شماره
صفحات -
تاریخ انتشار 2012