The ABCD3 score is an extension of the ABCD2 and ABCD3 scores for predicting the risk of stroke in a patient with a history of transient ischemic attack (TIA). This includes information found on imaging studies.
Patient selection: transient ischemic attack (TIA)
Outcome: near-term stroke
Parameters from the ABCD2:
(1) age in years
(2) blood pressure in mm Hg
(3) clinical features
(4) duration of symptoms in minutes
(5) diabetes
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 60 years of age
|
0
|
|
|
>= 60 years of age
|
1
|
|
blood pressure in mm Hg
|
< 140/90 mm Hg
|
0
|
|
|
>= 140/90 mm Hg
|
1
|
|
clinical findings
|
normal
|
0
|
|
|
speech impairment without weakness
|
1
|
|
|
unilateral weakness
|
2
|
|
duration of symptoms
|
< 10 minutes
|
0
|
|
|
10 - 59 minutes
|
1
|
|
|
>= 60 minutes
|
2
|
|
diabetes mellitus
|
absent
|
0
|
|
|
present
|
1
|
Additional parameters:
(6) "dual" TIA (TIA prompting medical attention AND >= 1 TIA in preceding 7 days)
(7) stenosis of the ipsilateral carotid artery
(8) diffusion-weighted imaging
|
Parameter
|
Finding
|
Points
|
|
dual TIA
|
absent
|
0
|
|
|
present
|
2
|
|
stenosis of ipsilateral carotid artery
|
< 50%
|
0
|
|
|
>= 50%
|
2
|
|
diffusion-weighted imaging
|
acute hyperintensity
|
2
|
|
|
other
|
0
|
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• The higher the score the greater the risk of stroke.
• A patient in the high risk group should undergo immediate evaluation and initiation of stroke preventive measures.
|
Total Score
|
Risk Group
|
Risk of Stroke in 7 Days
|
Risk of Stroke in 90 Days
|
|
0 to 3
|
low
|
trace
|
0.6%
|
|
4 or 7
|
moderate
|
0.7%
|
2%
|
|
8 to 13
|
high
|
4.3%
|
8.3%
|
