Even though the risk of recurrent stroke is quite high in patients that have suffered a transient ischemic attack (TIA) or a minor stroke, uncertainty of how to diagnose and treat such patients is widespread. Early, aggressive treatment of patients who have suffered a transient ischemic attack or minor stroke have been shown to significantly reduce the risk of recurrent stroke.
The ABCD score (Oxfordshire Community Stroke Project) is used to stratify the 30-day stroke risk in patients that have suffered a transient ischemic attack (TIA). The value of this scoring system is that it can predict which patient will benefit from a more aggressive treatment regimen for the prophylaxis of a recurrent stroke. The ABCD score is based on points summed from 5 clinical factors:
Clinical features including unilateral weakness
Speech impairment without weakness
Duration of Impairment
A score of 5 to 6 was associated with a significant increase in the 30-day risk of developing a stroke following a transient ischemic attack (TIA). A newer ABCD2 (squared) score includes a 6th factor such as diabetes to increase its validation.
Risk factors for ischemic stroke comprise modifiable and nonmodifiable causes. Identification of risk factors in a patient before they develop an ischemic stroke is essential in order for a medical provider to institute appropriate treatment and a prevention plan. Even after a stroke has affected a patient, prevention of a recurrent stroke is of prime importance.
Life style issues (excessive alcohol intake, tobacco use, illicit drug use, obesity, sedentary life)
Patients who have suffered a transient ischemic attack (TIA) and were evaluated by means of Computed tomography (CT) or magnetic resonance imaging (MRI) of the head with or without magnetic resonance angiography (MRA) and carotid Doppler studies were more prone to be accurately diagnosed. The addition of a transesophageal echocardiography further improved the ability to accurately diagnose the cause of the transient ischemic attack and institute proper prophylactic measures to prevent a recurrent stroke.
Medications known as antiaggregation agents are used to prevent strokes. Aspirin, clopidogrel, ticlopidine and dipyridamole are some of the drugs used for this purpose. Some of the latter medications are used in combination with aspirin to increase their efficacy in preventing strokes.
If you are suffering from complications due to a delayed diagnosis of a stroke or the mismanagement of a stroke, let Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten review the specifics of your case. . At Gorovitz & Borten we have the necessary experience, understanding and resources available to properly evaluate the complications of a stroke, and give you a timely assessment of its merits.
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