Early Stroke Risk After a Transient Ischemic Attack Can It Be Minimized

See related article, pages 1717–1721 . Early stroke recurrence after a transient ischemic attack (TIA) or minor stroke, as is becoming clearer lately, is much higher than previously reported. Recent studies found the overall risk to be as high as 8% within a week1 and up to 20% within a 3-month period.2,3 Along with these observations, numerous studies were published, suggesting different scores and methods aiming to identify those patients, which carry the highest risks. The study by Ois et al,4 published in this issue of Stroke , addresses this important issue as well. Yet, with the influx of data—some relating to TIAs only and some mixing TIAs and minor stroke and not all in full agreement—uncertainties have risen. Therefore, there is a need to put some order into the list of risk factors and, more importantly, into the various possible effective means of reducing this high risk. Early on, much attention has been paid to the clinical profile of the patients at risk: the California score suggested 5 major factors, while the Oxford area score suggested 4 other, mainly similar, factors (the ABCD Score). Other scores exist too, but these 2 have joined forces and recently a consensus was reached resulting in a validated score of 5 factors with 7 points—the ABCD2 score.3 It consists of the following: A, for age: 1 point for age over 60 years; B, for blood pressure (BP): 1 point for BP over 140/90; C, for clinical features: 2 points for limb paresis, 1 point for dysphasia, none for sensory symptoms only; D, for duration: 2 points for symptoms over 1 hour, 1 point when over …