An improved scoring system for identifying patients at high early risk of stroke and functional impairment after an acute transient ischemic attack or minor stroke.

International Journal of Stroke : Official Journal of the International Stroke Society
Shelagh B CouttsVISION Study Group

Abstract

Risk of a subsequent stroke following an acute transient ischemic attack (TIA) or minor stroke is high. The ABCD(2) tool was proposed as a method to triage these patients using five clinical factors. Modern imaging of the brain was not included. The present study quantified the added value of magnetic resonance imaging (MRI) factors to the ABCD(2) tool. Patients with TIA or minor stroke were examined within 12 h and had a brain MRI within 24 h of symptom onset. Primary outcomes were recurrent stroke and functional impairment at 90 days. A new tool, ABCD(2)+MRI, was created by adding diffusion-weighted imaging lesion and vessel occlusion status to the ABCD(2) tool. The predictive accuracy of both tools was quantified by the area under the curve (AUC). One hundred and eighty patients were enrolled and 11.1% had a recurrent stroke within 90 days. The predictive accuracy of the ABCD(2)+MRI was significantly higher than ABCD(2) (AUC of 0.88 vs. 0.78, P=0.01). Those with a high score (7-9) had a 90-day recurrent stroke risk of 32.1%, moderate score (5-6) risk of 5.4%, and low score (0-4) risk of 0.0%. The ABCD(2) tool did not predict risk of functional impairment at 90 days (P=0.33), unlike the ABCD(2)+MRI (P=0.02): high score (22.9%...Continue Reading

References

Nov 24, 1969·JAMA : the Journal of the American Medical Association·G D FriedmanM Z Nichaman
Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Dec 1, 1996·Stroke; a Journal of Cerebral Circulation·J M FerroA V Salgado
Jun 4, 1999·Stroke; a Journal of Cerebral Circulation·C S KidwellJ L Saver
Jan 9, 2001·JAMA : the Journal of the American Medical Association·S C JohnstonS Sidney
Oct 6, 2001·Stroke; a Journal of Cerebral Circulation·W J JonesJ F Meschia
Feb 13, 2003·Archives of Neurology·Georg HagemannOtto W Witte
Mar 5, 2004·Journal of the American College of Cardiology·Lori MoscaUNKNOWN World Heart Federation
Mar 27, 2004·Lancet·P M RothwellUNKNOWN Carotid Endarterectomy Trialists Collaboration
Mar 31, 2004·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Michael EliasziwUNKNOWN North American Symptomatic Carotid Endarterectomy Trial Group
Aug 24, 2004·Stroke; a Journal of Cerebral Circulation·Francisco PurroyJosé Alvarez-Sabín
Mar 9, 2005·Neurology·Peter M Rothwell, Charles P Warlow
May 26, 2005·Stroke; a Journal of Cerebral Circulation·K S ButcherUNKNOWN EPITHET Investigators
Jun 2, 2005·Annals of Neurology·Shelagh B CouttsAndrew M Demchuk
Aug 24, 2005·Neurology·S B CouttsUNKNOWN VISION Study Group
Feb 14, 2006·Stroke; a Journal of Cerebral Circulation·Jean-Martin BoulangerUNKNOWN VISION Study Group
Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
Jun 10, 2006·Stroke; a Journal of Cerebral Circulation·Brett L CucchiaraScott E Kasner
Aug 11, 2006·The New England Journal of Medicine·Pierre AmarencoUNKNOWN Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators
Oct 12, 2007·Lancet·Peter M RothwellUNKNOWN Early use of Existing Preventive Strategies for Stroke (EXPRESS) study

❮ Previous
Next ❯

Citations

Apr 18, 2009·Journal of Neurology·Christian WeimarUNKNOWN German Stroke Study Collaboration
May 4, 2011·Current Atherosclerosis Reports·Sharon Poisson, S Claiborne Johnston
Jul 8, 2010·International Journal of Emergency Medicine·Min LouMagdy Selim
Feb 27, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Hans-Christoph Diener, Christian Weimar
May 11, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S T EngelterP A Lyrer
Jun 13, 2009·Stroke; a Journal of Cerebral Circulation·Amy FothergillAlejandro A Rabinstein
Oct 17, 2009·Stroke; a Journal of Cerebral Circulation·Wade S SmithKaren L Furie
Jun 8, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Michael D Hill, Shelagh B Coutts
Jun 9, 2012·AJNR. American Journal of Neuroradiology·G Ssi-Yan-KaiF Bonneville
Jun 1, 2012·Translational Stroke Research·Kavian GhandehariKosar Ghandehari
Oct 10, 2009·Expert Review of Cardiovascular Therapy·Philippe CouillardShelagh B Coutts
Nov 20, 2012·Neurologia i neurochirurgia polska·Kavian GhandehariKosar Ghandehari
Jun 7, 2011·Neuroimaging Clinics of North America·Greg Zaharchuk
Feb 15, 2011·Clinical Neurology and Neurosurgery·Ran MengXiaoying Wang
Jul 8, 2010·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Aleksandra M PavlovicStephen M Davis
Nov 26, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·S B CouttsUNKNOWN Calgary CTA study group
Nov 26, 2009·Annals of Neurology·David S Liebeskind
Jun 24, 2009·Internal Medicine Journal·D S CrimminsUNKNOWN National Stroke Foundation Acute Stroke Guidelines Expert Working Group
Jun 29, 2010·Annals of Neurology·J Donald Easton, Edward Feldmann
May 8, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·N NasrV Larrue
Oct 3, 2013·Annals of Neurology·Miriam BrazzelliJoanna M Wardlaw
Oct 24, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·Thomas JeerakathilUNKNOWN ASPIRE Investigators
Sep 4, 2015·Nature Reviews. Neurology·Hans-Christoph Diener, Benedikt Frank
Apr 14, 2016·AJR. American Journal of Roentgenology·Raymond W GramsKambiz Nael
May 10, 2015·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Ran MengXunming Ji
May 23, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Ali Arhami DolatabadiKazem Jamali
Mar 17, 2015·PloS One·Changqing ZhangUNKNOWN Chinese IntraCranial AtheroSclerosis (CICAS) Study Group
Jul 30, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Deepak GuptaMaher Saqqur
Oct 16, 2016·Emergency Medicine Clinics of North America·Andrea Duca, Andy Jagoda
Nov 2, 2016·The Neurologist·Hana KarpatováRobert Mikulík
Dec 22, 2017·F1000Research·Camilo R GomezJose Biller
May 2, 2013·The Cochrane Database of Systematic Reviews·Charlie S Y ChungSuzanne Hagen
Aug 3, 2013·Stroke; a Journal of Cerebral Circulation·Negar AsdaghiShelagh B Coutts
Jan 5, 2011·Stroke; a Journal of Cerebral Circulation·Jie Jin WangPaul Mitchell

❮ Previous
Next ❯

Methods Mentioned

BETA
imaging techniques

Software Mentioned

ABCD

Related Concepts

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.