TY - JOUR
T1 - Risk scores for transient ischemic attack
AU - Wolf, M. E.
AU - Held, V. E.
AU - Hennerici, M. G.
N1 - Publisher Copyright:
Copyright © 2014 S. Karger AG, Basel.
PY - 2014
Y1 - 2014
N2 - The risk of recurrent ischemic stroke after a transient ischemic attack (TIA) has been reported to be 5-10%, and is elevated especially within the first days after the index event. Since TIA primarily has a good outcome without persisting new deficits, interest has been growing to predict stroke recurrence after TIA. This has led to the development of scores, initially for long-term prognosis such as the Stroke Prognosis Instrument (SPI) or the Hankey score, which both have shown a good predictive value at 1 or 2 years after TIA. Risk factors such as age, hypertension or cardiovascular disease were integrated in these systems. Since the early risk prediction for stroke in patients presenting within 24 h after onset of symptoms became clinically more and more relevant in emergency stroke units, the ABCD score (for the predictive factors Age, Blood pressure, Clinical symptoms, Duration of symptoms) was developed. Validation was promising, and hence further scores were developed, which entailed a large number of studies trying to validate these systems or to improve them (e.g. ABCD2, ABCD2I, ABCD3, ABCD3I, CIP model, ASPIRE approach, ABCDE+ etc.). The main approaches were to include imaging results (such as DWI positivity) or etiologic considerations (e.g. carotid stenosis or atrial fibrillation). However, these new scores necessitate an extensive diagnostic workup, and therefore can only be used in large stroke centers. Currently, for acute TIA management, the use of ABCD2 is recommended in several guidelines.
AB - The risk of recurrent ischemic stroke after a transient ischemic attack (TIA) has been reported to be 5-10%, and is elevated especially within the first days after the index event. Since TIA primarily has a good outcome without persisting new deficits, interest has been growing to predict stroke recurrence after TIA. This has led to the development of scores, initially for long-term prognosis such as the Stroke Prognosis Instrument (SPI) or the Hankey score, which both have shown a good predictive value at 1 or 2 years after TIA. Risk factors such as age, hypertension or cardiovascular disease were integrated in these systems. Since the early risk prediction for stroke in patients presenting within 24 h after onset of symptoms became clinically more and more relevant in emergency stroke units, the ABCD score (for the predictive factors Age, Blood pressure, Clinical symptoms, Duration of symptoms) was developed. Validation was promising, and hence further scores were developed, which entailed a large number of studies trying to validate these systems or to improve them (e.g. ABCD2, ABCD2I, ABCD3, ABCD3I, CIP model, ASPIRE approach, ABCDE+ etc.). The main approaches were to include imaging results (such as DWI positivity) or etiologic considerations (e.g. carotid stenosis or atrial fibrillation). However, these new scores necessitate an extensive diagnostic workup, and therefore can only be used in large stroke centers. Currently, for acute TIA management, the use of ABCD2 is recommended in several guidelines.
UR - http://www.scopus.com/inward/record.url?scp=84902018639&partnerID=8YFLogxK
U2 - 10.1159/000351891
DO - 10.1159/000351891
M3 - Article
C2 - 24157556
AN - SCOPUS:84902018639
SN - 1660-4431
VL - 33
SP - 41
EP - 68
JO - Frontiers of Neurology and Neuroscience
JF - Frontiers of Neurology and Neuroscience
ER -