ABCD(2) as a screening tool for cerebral infarction on stroke MRI?

Eur Neurol. 2012;67(5):315-20. doi: 10.1159/000336267. Epub 2012 Apr 27.


Background: The newly proposed transient ischemic attack (TIA) definition demands for MRI exclusion of infarction. Due to limited resources other tools than MRI predicting tissue infarction would be valuable. We hypothesized that ABCD(2) risk score is a valid screening tool for diffusion-weighted imaging (DWI) lesions.

Methods: TIA patients were prospectively enrolled in an observational MRI study to receive acute and follow-up stroke MRI. ABCD(2) scores were calculated, and sociodemographics and risk factors were recorded.

Results: One hundred and thirty-two TIA patients were enrolled over nine months. Five patients were excluded due to different diagnosis. Forty-five of the 127 remaining patients showed acute ischemic lesions on DWI. Median ABCD(2) scores for DWI-negative and -positive patients were 4 and 5, respectively. Ordinal, trichotomized and dichotomized ABCD(2) were significantly associated to DWI. Univariate analysis of single score items and other risk factors demonstrated unilateral weakness, duration of symptoms and smoking as predictive for DWI restrictions. In multivariate analysis unilateral weakness remained significant.

Conclusions: High-risk ABCD(2) score due to the impact of hemiparesis is associated with the occurrence of DWI lesions but is still not accurate enough for a reliable differentiation of cerebrovascular events with and without MRI lesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / etiology*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Ischemic Attack, Transient / complications*
  • Logistic Models
  • Magnetic Resonance Imaging / methods*
  • Male
  • Mass Screening
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Severity of Illness Index*