Transient ischaemic attack
TIA as a medical emergency, telling it from its mimics, why ABCD2 alone shouldn't triage, and same-day imaging and secondary prevention.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- TIA is a medical emergency. Stroke risk is front-loaded: much of the 90-day risk falls in the first 48 hours.
- Urgent assessment and treatment cut early stroke by about 80% (EXPRESS). In TIAregistry.org, where most patients were seen in specialist units within 24 hours, stroke risk was about 5% at 1 year and about 9.5% at 5 years.
- Everyone with suspected TIA should be assessed, imaged and started on treatment within 24 hours. Don't triage on ABCD2 alone.
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Sources
- Assessing Fitness to Drive (AP-G56), other neurological conditions: stroke and transient ischaemic attack standardsAU/NZAustroads and National Transport Commission, 2022
- Australian and New Zealand Living Clinical Guidelines for Stroke ManagementAU/NZStroke Foundation, Living guideline, accessed November 2026
- Assessing Fitness to Drive (AP-G56), Neurological conditionsAU/NZAustroads and National Transport Commission, 2022
- What is a TIA? (no driving for 2 weeks after a TIA, 4 weeks with a commercial licence)AU/NZStroke Foundation, accessed November 2026
- THALES (NCT03354429) eligibility: TIA with ABCD2 6 or more or symptomatic 50% or greater stenosis, or ischaemic stroke with NIHSS 5 or less, within 24 hoursClinicalTrials.gov, registry record
- Diagnosis, workup, risk reduction of transient ischemic attack in the emergency department setting: a scientific statementAmerican Heart Association and American Stroke Association (Stroke), 2023
- Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS). Lancet 2007;370:1432-42The Lancet, 2007
- One-year risk of stroke after transient ischemic attack or minor stroke (TIAregistry.org). N Engl J Med 2016;374:1533-42New England Journal of Medicine, 2016
- Five-year risk of stroke after TIA or minor ischemic stroke (TIAregistry.org). N Engl J Med 2018;378:2182-90New England Journal of Medicine, 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy