Kumar & Clarks I

Question 1

What score is used to stratify stroke risk in the first 2 days of having a TIA?
Describe the score range etc

Answer 1

ABCD^2 score:
Age >60 (1 point)
BP >140mmHg systolic and/or >90mmHg diastolic (1 point)
Clinical Features: 
Unilateral Weakness (2 points)
Isolated Speech disturbance (1 point)
Other (0 points)
Duration of symptoms:
>60 mins (2 points)
10 - 59 mins (1 point)
<10 mins (0 point)
Presence of diabetes (1 point)
A score of <4 is minimal risk whereas a score of >6 within 7 days of TIA is high risk.

Question 2

What is carotid endarterectomy (CEA)?

Answer 2

Carotid Endarterectomy is a surgical procedure used to reduce the risk of stroke by correcting stenosis in the common carotid artery. It is done through the removal of material inside an artery.

Question 3

For which conditions is Carotid Endarterectomy conducted?

Answer 3

TIA
Amaurosis Fugax - sudden transient loss of vision in one eye
R.I.N.D. Reversible Ischaemic Neurological Deficit

Question 4

What is the treatment of TIA?

Answer 4

1. Conservative: Modification of vascular risk factors - smoking, hypertension, statins
2. Medications: Antiplatelets such as Aspirin 300MG OD, then anticoagulate with Heparin and Warfarin or Dabigatran.
3. Surgical: Early Endarterectomy for symptomatic patients with 70 - 99% carotid artery stenosis (within 1 week)