dermographism

pericarditis

time is brain - TIA's - national stroke strategy

20% risk of a full cva within 1st four weeks after a TIA
investigating and treating high-risk patients with TIA within 24 hours could produce an 80% reduction in those who progress to a full CVA

assessment - ABCD2 score

* A - age - if over 60 years 1 point
* B - blood pressure at presentation if over 140/90 = 1 point
* C - clinical features - unilateral weakness = 2 points : speech disturbance without weakness = 1 point
* D1 - duration of symptoms - over 60 minutes = 2 points, 10 - 59 minutes = 1 point
* D2 - presence of diabetes = 1 point

score - low risk 0-3 points, moderate risk 4-5 points, high risk 6-7 points

Management
* aspirin, 300mg stat
* driving
* referral within 24 hours for those with ABCD2 score equal or over 4 (lower risk best investigated within 7 days)
***80% of TIA's need Carotid Artery assessment
***if clinical need - echo, 24 hr ECG in 48 hours

* all patients followed up within a month- allowsmedication and risk factor assessment