ABCD2 | Risk of Stroke after TIA

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Use this calculator to calculate the risk of stroke after TIA (transient ischemic attack) and guide urgency for workup and/or admission to hospital.

Age ≥60?
BP ≥140/90 mm Hg at initial evaluation?
Clinical Features:
Duration of Symptoms
Diabetes
_

About this calculator

The ABCD2 system is a quick clinical score that can help predict early risk of stroke in the first two days after transient ischemic attack (TIA). The early stroke rates in acute TIA patients were reported by Johnston and colleagues based on combined analysis of 6 cohorts with a total of 4799 TIA patients who were evaluated within 48 hours of TIA. The diagnosis of TIA was made by the initial treating physician, and therefore the usefulness of the scale may be generalized beyond stroke specialists.

ABCD2 is scored as follows:

Age

≥60 years: 1 point
<60 years: 0 points

Blood pressure elevation when first assessed after TIA:

Systolic ≥140 mmHg: 1 point
Systolic <140 mmHg: 0 points

Clinical features:

Unilateral weakness: 2 points
Isolated speech disturbance: 1 point
Other: 0 points

Duration of TIA symptoms:

≥ 60 minutes: 2 points
10 to 59 minutes: 1 point
<10 minutes: 0 points

Diabetes:
Present: 1 point
Absent: 0 points

Citations

Rothwell PM, et al.  A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack.  Lancet. 2005;366(9479):29-36.

Johnston SC, et al.  Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack.  Lancet. 2007;369(9558):283-92._

Contributor

QxMD Neurology contributing author: Dr. Marc Lazarro, MD