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Mason Rubianto Samudra Andi Yusuf Stefano Giovani

Abstract

Background : Atrial fibrillation (AF) is an independent risk factor for stroke. The role of AF in transient ischemic attack (TIA) is less common. Thus, this situation cannot be underestimated because both TIA and AF are increasing the risk of a patient to get stroke.


Case : An 80 years old woman presented with speech disturbance and disorientation which lasted for 2 hours. Patients look confused with glasgow coma scale total 13 (E4V3M6), blood pressure was 150/80 and heart rate 147 beats/min irregular. From neurological examination, there was paresis nervus facialis central and nervus hypoglossus but completely resolved under 24 hours. Her electrocardiogram showed an AF. Working diagnosis for this patient were TIA with AF and hypertension stage 1.


Discussion : The early risk of stroke seems to be best predicted with ABCD2 score, which is calculated by summing up points for five independent factors: (1) age, (2) blood pressure, (3) clinical features of TIA, (4) duration of TIA and (5) diabetes. The ABCD2 score of this patient is 5 which classified as moderate risk.


Conclusion : These patients require a comprehensive approach and additional an imaging consideration because there are a moderate to higher chance of stroke recurrence.


Keywords : Atrial Fibrillation, ABCD2 Score, Stroke, Transient Ischemic Attack

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