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(Stroke. 2006;37:1139.)
© 2006 American Heart Association, Inc.

Controversies in Stroke

Patients With Transient Ischemic Attack Do Not Need To Be Admitted to Hospital for Urgent Evaluation and Treatment

Against

Richard I. Lindley, MBBS, MD, FRCP(Edin), FRACP

From the Department of Geriatric Medicine, Westmead Hospital (C24), University of Sydney, NSW.

Correspondence to Richard I. Lindley, Department of Geriatric Medicine, Westmead Hospital (C24), University of Sydney, NSW 2006. E-mail richard_lindley@wmi.usyd.edu.au

Key Words: transient ischemic attack

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The essence of the assessment of a patient with suspected transient ischemic attack (TIA) is to confirm the diagnosis, identify and treat the cause, and start effective secondary prevention to prevent a disabling or fatal vascular event. In general, admission to hospital is required for patients who are medically unstable, those who have become dependent or require complex care that is unfeasible or unavailable elsewhere. You do not need to be admitted to hospital because of a TIA, but this is often done because of the absence of an alternative. Many TIA clinics now offer a "one-stop" service for which the patient is assessed, investigated (or investigated before the appointment), and given results at the same session.¹ The chief problem of such a clinic is that patients may experience a completed stroke (or other vascular disaster) before being seen, so delays must be eliminated.^2,3 Solutions include immediate access to regular clinics (by accepting telephone, email, or faxed referrals) and better public recognition of the seriousness of a TIA or minor stroke.

Confirming the diagnosis or identifying one of the many TIA mimics is an important aspect of a TIA clinic because about one third of referrals do not have cerebrovascular disease.⁴ In addition, the wide variety of neurological and general medical conditions that mimic TIA provide an invaluable resource for medical training. Appropriately trained personnel are vital, and the more senior personnel (including consultant specialists) who run TIA clinics are preferred over the typically less experienced staff initially assessing patients . . . [Full Text of this Article]

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