TIA
(Transient Ischemic Attack)

Ref. ABCD2 Score : Transient Ischemic Attack (TIA): Prognosis and Key Management Considerations

Diagnosis
(มีสิ่งต่อไปนี้ ให้นึกถึง)
  1. Sudden onset
  2. อาการดีขึ้น ใน 24 hr
  3. Risk factor : age , U/D
PE
  • Unilateral paresis

ควร Workup cause

ABCD2 Score
The prediction of short-term stroke risk after a transient ischemic attack (TIA). The score is optimized to predict the risk of stroke within 2 days after a TIA, but also predicts stroke risk within 90 days.

Risk factors
Point
Age ≥ 60 yr
 1
Hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) 1
Clinical feature of TIA
Unilateral weakness with/without speech impairment) 2
Only speech impairment) 1
Duration
60 mins 2
10-59 mins 1
DM 1
Score

0-3 (1.0%)* : Observation may be unnecessary if no other indication

4-5 (4.1%)* : Stroke unit observation 48 hours

6-7 (8.1%)* : Admit Stroke unit

* Risk in 2 days stroke

Antithrombotic Therapy

Atherothrombotic TIA

clopidogrel, or aspirin alone.

Cardioembolic TIA:

aspirin 325 mg daily; clopidogrel 75 mg daily if intolerant to aspirin.

Hypertension

<140/90 mm Hg or <130/80 mm Hg for diabetics

ACE inhibitor alone or in combination with a diuretic, or with an angiotensin-receptor blocker

Lipids

(<100mg/dl)