Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Failure to Prevent Stroke
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:

  • Age
  • Blood pressure
  • 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

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.

Nonmodifiable risk factors for stroke include:

  • Age
  • Race
  • Sex
  • Ethnicity
  • History of migraine headaches
  • Sickle cell disease
  • Fibromuscular dysplasia
  • Heredity

Modifiable risk factors for stroke include:

  • Hypertension (high blood pressure)
  • Diabetes mellitus
  • Cardiac disease (atrial fibrillation, valvular disease, mitral stenosis,
    foramen ovale, structural anomalies)
  • Hypercholesterolemia
  • Transient ischemic attacks (TIAs)
  • Carotid stenosis
  • Hyperhomocystinemia
  • 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.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question
or concern.

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