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The use of FAST and ABCD2 scores in posterior circulation, compared with anterior circulation, stroke and transient ischemic attack
  1. G Gulli1,2,
  2. H S Markus1
  1. 1Clinical Neuroscience, St George's University of London, London, UK
  2. 2Division of Neurology, Civic and University Hospitals of Verona, Verona, Italy
  1. Correspondence to Dr Giosuè Gulli, Clinical Neuroscience, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK; ggulli{at}

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The effectiveness of early interventions to prevent stroke after transient ischemic attack (TIA) has led to the need for simple screening methods to identify patients with acute stroke and TIA for intervention.1 The Face Arm Speech Test (FAST) score has been developed to assess whether a patient is likely to have an acute stroke and in particular to identify patients as potential candidates for thrombolysis.2 The ABCD2 score has been developed as a screening tool to identify patients with TIA and minor stroke who are at particularly high risk of recurrent stroke and therefore need urgent investigation and treatment.3 Both have been primarily evaluated in groups of unselected stroke and TIA patients, the majority of whom have anterior circulation stroke.

Symptoms and signs associated with posterior circulation stroke differ significantly from those associated with anterior circulation stroke. We tested whether FAST and ABCD2 are less sensitive in patients with posterior, compared with anterior, cerebrovascular events.

Two hundred and sixteen consecutive patients with posterior circulation ischaemic stroke or TIA presenting as emergencies to our stroke service were recruited as previously described.4 Clinical details including history, examination and results of investigations were collected prospectively within 12 h from hospital admission, on a standard stroke register proforma. As a control group, data …

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  • Funding GG was funded by the Stroke Association.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the St George's University Ethical Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.