ABCD² Score

The ABCD2 score (Age, Blood Pressure, Clinical Features, Duration of Symptoms, and Diabetes) is a clinical stratification tool used to estimate the short-term risk of stroke (ischemic stroke) after a transient ischemic attack (TIA). It was developed to help clinicians in emergency settings or outpatient clinics decide the urgency of investigation and management, such as the need for hospitalization versus rapid outpatient assessment. The score is an acronym for its five components, with points assigned as follows: (1)Age: 1 point if the patient is 60 years or older; (2)Blood Pressure: 1 point if the systolic blood pressure is ≥ 140 mmHg or the diastolic blood pressure is ≥ 90 mmHg at the time of evaluation; (3)Clinical Features: 2 points for unilateral motor weakness (e.g., in the face, arm, or leg), or 1 point for speech disturbance (aphasia or dysarthria) without motor weakness; (4)Duration of Symptoms: 2 points if symptoms lasted 60 minutes or more, or 1 point if they lasted between 10 and 59 minutes (0 points for < 10 minutes); (5)Diabetes: 1 point if the patient has a history of diabetes mellitus. The total score ranges from 0 to 7. A higher score correlates with a higher risk of stroke, particularly in the subsequent 2, 7, and 90 days. For example, scores of 0-3 are often considered low risk, 4-5 moderate risk, and 6-7 high risk, guiding the intensity of follow-up and intervention.