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The ABCD2 score stratifies the short-term risk of stroke after a transient ischemic attack (TIA) using Age, Blood pressure, Clinical features, Duration of symptoms, and Diabetes. The total ranges 0–7 and estimates the 2-day risk of subsequent stroke.
ABCD2 = Age ≥ 60 (1) + BP ≥ 140/90 (1) + Clinical features (weakness 2, speech-only 1, other 0) + Duration (≥ 60 min 2, 10–59 min 1, < 10 min 0) + Diabetes (1) → total 0–7
Total 0–7. 2-day stroke risk: 0–3 → 1.0%; 4–5 → 4.1%; 6–7 → 8.1%.
The ABCD2 score was derived and validated by Johnston and colleagues (Lancet 2007) from multiple TIA cohorts and is among the most widely used clinical tools for TIA risk stratification. Age 60 years or older adds 1 point; blood pressure ≥ 140/90 mmHg adds 1; unilateral weakness adds 2 and speech disturbance without weakness adds 1; symptoms lasting ≥ 60 minutes add 2, 10–59 minutes add 1, and under 10 minutes add 0; and diabetes adds 1. The 2-day stroke risk ranges from about 1% (score 0–3) to about 8% (score 6–7).
Specialty
NeurologyCategory
NeurologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-16
Formula
Keywords
Normal Range
Total 0–7. 2-day stroke risk: 0–3 → 1.0%; 4–5 → 4.1%; 6–7 → 8.1%.
| Classification | Range |
|---|---|
Low risk 2-day stroke risk ≈ 1.0% | 0–3 |
Moderate risk 2-day stroke risk ≈ 4.1% | 4–5 |
High risk 2-day stroke risk ≈ 8.1% | 6–7 |
Stratifies the short-term (2-day) risk of stroke after a transient ischemic attack using age, blood pressure, clinical features, duration of symptoms, and diabetes, giving a total of 0–7.
Scores of 0–3 are low risk with a 2-day stroke risk of about 1.0%; 4–5 moderate (≈ 4.1%); and 6–7 high (≈ 8.1%). All patients with a suspected TIA need urgent specialist evaluation regardless of the score.
The ABCD2 score enables rapid, evidence-based triage of TIA patients, directing the highest-risk patients to same-day assessment and early secondary prevention that reduces the early risk of stroke.
A 72-year-old hypertensive diabetic woman had 90 minutes of right-hand and face weakness that fully resolved. On arrival BP is 165/95.
Inputs:
ABCD2 7/7 — HIGH short-term stroke risk (2-day risk ≈ 8.1%); arrange same-day specialist evaluation.
It indicates moderate risk, with a 2-day stroke risk of about 4.1%; patients should be seen urgently, typically within the same day.
Yes. Modern pathways incorporate MRI findings and carotid imaging; a low ABCD2 does not replace urgent assessment and secondary prevention.
Chronic secondary prevention decisions
Deficit quantification when stroke has occurred
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. The ABCD2 score complements, but does not replace, urgent specialist assessment, neuroimaging, and initiation of secondary prevention.