His risk of a subsequent stroke can be calculated using the ABCD2 scoring system.
The scoring is calculated according to the following clinical features:
- A: Age > 60 = 1 point
- B: Blood pressure > 140/90 = 1 point
- C: Clinical features of the TIA
- Unilateral weakness = 2 points
- Speech disturbance without weakness = 1 point
- D1: Duration of symptoms
- > 60 minutes = 2 points
- 10-59 minutes = 1 point
- < 10 minutes + 0 points
- D2: Diabetes = 1 point
The corresponding two-day risks for a subsequent stroke are:
- 0-3 = 1%
- 4-5 = 4%
- 6-7 = 8%
He is at high risk of a subsequent stroke as he has an ABCD2 score of 5, and should therefore be given a stat dose of 300 mg aspirin and seen by a specialist within 24 hours of onset of his symptoms.
It is also important to address his risk factors and to think about secondary prevention, but this would be more appropriate once the diagnosis is confirmed and following seeing the stroke team.
For further information please view the guidance from NICE: