Transient ischaemic attacks

Question 1

Mx

Answer 1

give aspirin 300 mg immediately (unless bleeding disorder –> immediate imaging)

Question 2

if the patient has had more than 1 TIA (‘crescendo TIA’) or has a suspected cardioembolic source or severe carotid stenosis:

Answer 2

Specialist review

Question 3

if the patient has had more than 1 TIA (‘crescendo TIA’) or has a suspected cardioembolic source or severe carotid stenosis:

Answer 3

Specialist review

Question 4

If the patient has had a suspected TIA in the last 7 days:

Answer 4

arrange urgent assessment (within 24 hours) by a specialist stroke physician

Question 5

if the patient has had a suspected TIA which occurred more than a week previously:

Answer 5

refer for specialist assessment as soon as possible within 7 days

Question 6

Can people drive after TIA

Answer 6

Not until seen by specialist

Question 7

Can people drive after TIA

Answer 7

Not until seen by specialist

Question 8

Imaging for TIA

Answer 8

MRI
Urgent carotid doppler

Question 9

Secondary prevention

Answer 9

clopidogrel is recommended first-line (as for patients who’ve had a stroke)

2nd liine aspirin + dipyridamole

Staitn

Question 10

if the patient has suffered stroke or TIA in the carotid territory and is not severely disabled

should only be considered if
carotid stenosis > 70% according European Carotid Surgery Trialists’ Collaborative Group criteria or
> 50% according to North American Symptomatic Carotid Endarterectomy Trial criteria

Answer 10

Carotid endarterectomy

Question 11

if the patient has suffered stroke or TIA in the carotid territory and is not severely disabled

should only be considered if
carotid stenosis > 70% according European Carotid Surgery Trialists’ Collaborative Group criteria or
> 50% according to North American Symptomatic Carotid Endarterectomy Trial criteria

Answer 11

Carotid endarterectomy