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ABCD² Score for TIA

Estimates early stroke risk after a TIA — but it misses high-risk patients it was never built to see, so it decides less than it looks like it decides.

Low risk
ABCD² 0–3 · ~1.0% 2-day stroke risk
Outpatient workup with urgent follow-up may be reasonable
Only if afib, carotid stenosis, and crescendo TIA are excluded — the score does not check them
0pts
Age
Blood pressure at initial evaluation
Clinical features
Duration of symptoms
Diabetes
Johnston SC, et al. Lancet. 2007 · ABCD² does not capture atrial fibrillation, carotid stenosis, or crescendo TIA — any of which is high-risk at ANY score. Posterior-circulation symptoms score 0. A low score does not clear a patient; pair with vascular imaging and clinical judgment.