The Application Value Of ABCD2 Score Uniting DSA To Predict The Recently Stroke Risk After Transient Infarction Attack

Background Transient Ischemic Attack (transient ischemic attack, TIA) is a risk warning signal of cerebral infarction, is the most important independent risk factor in ischemic attack. Currently the etiology and pathogenesis of TIA include microemboli theory, theory of hemodynamic changes, vascular spasm, carotid artery pressure and blood composition changes, microemboli theory is the researching focus now. Some studies show that a higher incidence of stroke within 7d of up to 12.8%, up to 21% after one year [1]. Thus screening the patients with high-risk of TIA and giving them correct treatment quickly is extremely important, which requires evaluation of TIA patients stratified patients with TIA to reduce the proportion of the development of stroke and medical resources. There are a variety of prognostic rating scales, such as California scale, ABCD scale, ABCD2 scale, but still lack of related evaluation. Another study suggests that the pathogenesis is also a key factor to influence the prognosis, but did not study the relationship between them. So we need to establish a rapid comprehensive evaluation method of screening high-risk patients as to quickly work out the right treatment options to reduce the risk of stroke after TIA in the first time. In this study, our aim to explore the application value of ABCD2 score uniting digital subtraction angiography (digital subtraction angiography, DSA)on predicting the recently stroke risk after TIAObjective To explore the application value of ABCD2 score uniting DSA on predicting the recently stroke risk after transient ischemic attack Subjects and methods Recalling the Eastern District of Qingdao University Medical College Hospital Department of Neurology hospitalized TIA patients,90 patients underwent DSA, according to ABCD2 score group, according to the DSA results are divided into groups≥50% stenosis and stenosis<50% group (DSA negative Zheyi included in this group). Selection and exclusion criteria:inclusion criteria①symptom duration<24h, and complete remission of brain CT excluded hemorrhagic②③④cases complete line DSA can be correctly ABCD2 score. Degree of stenosis by the North American symptomatic carotid stenosis test standard [2], the degree of stenosis (%)＝(1 - the narrowest diameter / narrow distal normal artery diameter)×100%, calculated by the DSA software automatically complete. Diagnosis of cerebral infarction according to the Fourth Conference on cerebrovascular disease by the diagnostic criteria [3]. All patients underwent head CT, the duration of the first seven days of the end of observation time. Statistical analysis of data using statistical software SPSS11.5. Group analysis of count data using X2 test, with P<0.05 for the difference was statistically significant.Results ABCD2 score and the relationship between secondary cerebral infarction.7d in 90 cases of TIA patients progressed to cerebral infarction in 13 cases 14% of the total number of cases.90 cases of TIA patients progress ABCD2 score≤3 points for the 16 cases of cerebral infarction, cerebral infarction was 1.9%, ABCD2 who score 4-5 points, cerebral infarction was 7.2%, ABCD2 score 5-6 persons, cerebral infarction rate was 12%, ABCD2 score 6-7 points were cerebral infarction was 20%. Low risk (0-3 points), medium risk (4-5 points) and high-risk (6-7 points) groups,7d, respectively, in the proportion of cerebral infarction (1.9%,7.2%,20%), and different stroke The incidence of cerebral infarction risk stratification were significantly different (P<0.05).≥50% stenosis group 2d of the incidence of cerebral infarction 14%,7d≥50% stenosis within the group and the blood vessels<50% group no significant difference in the incidence of cerebral infarction. Stenosis and the incidence of stroke after TIA.60 cases of TIA patients with DSA showed ICA system,48 patients (80%) stenosis, in which≥50% stenosis in 35 patients (68.3%). Simple intracranial arterial stenosis in 27 patients (45%), pure extracranial artery stenosis in 12 patients (20%).30 patients with DSA showed VBA system TIA patients,20 patients (66.7%) stenosis, in which≥50% stenosis 14 cases (46.7%). Simple intracranial arterial stenosis in 4 cases (13.3%), pure extracranial artery stenosis in 14 patients (46.7%). TIA within 7d after the incidence of stroke between the two groups no significant difference≥50% stenosis group,2d rate of increase in cerebral infarction.Conclusion ABCD2 score is an effective way to predict the recentlystroke risk after TIA. But it needs further observation. This study suggests that cerebral vascular screening is an important methond for TIA. DSA is an important pathogenesis of TIA inspection.