Transient ischemic attack natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Natural History
Complications
Complications of TIA include:
- Ischemic stroke
- Hemorrhagic stroke
- Cognitive dysfunction
- Recuurent TIA
- Anxiety
Prognosis
The prognosis of TIA depends on the possibilty of developing ischemic stroke in the future. There is 11 percent increased risk of ischemic stroke in patients having TIA for next seven days and 25-29% in next five years.[1] This is especially true in patients with TIA due to small-vessel disease (SVD) etiology with motor weakness (capsular warning syndrome).[1]
The ABCD2 score
The ABCD2 score can predict likelihood of subsequent stroke.[2][3]
The score is calculated as:
Age
- ≥ 60 years = 1 point
- Blood pressure at presentation ≥ 140/90 mm Hg = 1 point
Clinical features
- Unilateral weakness = 2 points
- Speech disturbance without weakness = 1 point
Duration of attack
- ≥ 60 minutes = 2 points
- 10–59 minutes = 1 point
- Diabetes = 1 point
Interpretation of score, the risk for stroke:
Score 0-3 (low)
- 2 day risk = 1.0%
- 7 day risk = 1.2%
Score 4-5 (moderate)
- 2 day risk = 4.1%
- 7 day risk = 5.9%
Score 6–7 (high)
- 2 day risk = 8.1%
- 7 day risk = 11.7%
References
- ↑ 1.0 1.1 Paul NL, Simoni M, Chandratheva A, Rothwell PM (2012). "Population-based study of capsular warning syndrome and prognosis after early recurrent TIA". Neurology. 79 (13): 1356–62. doi:10.1212/WNL.0b013e31826c1af8. PMC 3448742. PMID 22972645.
- ↑ Johnston SC, Rothwell PM, Nguyen-Huynh MN; et al. (2007). "Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack". Lancet. 369 (9558): 283–92. doi:10.1016/S0140-6736(07)60150-0. PMID 17258668.
- ↑ Rothwell PM, Giles MF, Flossmann E; et al. (2005). "A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack". Lancet. 366 (9479): 29–36. doi:10.1016/S0140-6736(05)66702-5. PMID 15993230.