0071643192.pdf

■ TheABCD^2 scorecan be used to predict likelihood of subsequent stroke
within 2 days (see Table 15.3).
■ Patients with moderate to high risk for stroke within 2 days should be
admitted for evaluation and treatment.

Hemorrhagic Stroke

Can be divided into intracerebral hemorrhage and subarachnoid hemorrhage

INTRACEREBRALHEMORRHAGE(ICH)

CAUSES

Intracerebral hemorrhage is an acute bleed into the brain parenchyma as a
result of:

■ Chronic hypertension (most common)
■ Amyloidosis
■ Cocaine or methamphetamine use
■ Vascular malformation
■ Anticoagulation or thrombolysis

SYMPTOMS/EXAM

■ Characterized by sudden onset and rapid progression of neurologic symp-
toms (see Table 15.4)
■ Headache
■ Nausea, vomiting
■ Patients usually present hypertensive.

NEUROLOGY

TABLE 15.3. ABCD^2 Score to Predict Subsequent Stroke in Patients with TIA

VARIABLE POINTS

Age >60 years 1

BP ≥140/90 mmHg 1

Unilateral weakness 2

Speech disturbance without weakness 1

Duration≥60 minutes 2

Duration 10—59 minutes 1

Diabetes 1

Risk for subsequent stroke:

Low: 0—3 points

Moderate: 3—4 points

High: 6—7 points

The most common location

for hemorrhagic stroke is the

putamen.

ABCD^2 Score:

Age

Blood pressure

Clinical features

Duration

Diabetes