TranslateTransient Ischemic Attacks (TIA)
Outpatients | Neurology
This condition is treated in the Neurology clinic.
Pre-referral work-up
History
An appointment for TIA clinic can only be obtained through direct discussion with the Stroke Registrar (within hours) or on call Consultant (after hours). The referral should be made after discussion.
Vascular risk factors: Smoking, hypertension, dyslipidaemia, diabetes, family history, obesity
ABCD2 score is a useful assessment tool in cases of TIA (not stroke) which assists in identifying those patients with a suspected or definite TIA who are at high risk of stroke however all cases of suspected TIA require urgent assessment regardless of their score.
| A | Age greater than or equal to 60 years | = 1 point |
| B | BP over 140 systolic ±diastolic greater than or equal to90 | = 1 point |
| C | Clinical: - Limb weakness - Speech disturbance | = 2 points = 1 point |
| D | Duration of TIA: greater than or equal to60 minutes 10-59 minutes under 10 minutes | = 2 points = 1 point = 0 points |
| D | Diabetes | = 1 point |
Ischemic stroke presenting within 4.5 hours are eligible for consideration of thrombolysis.
If the patient still has residual neurological symptoms or signs they should attend the Emergency Department immediately.
Tests
Tests to consider:
- CT brain - should be done prior to clinic appointment
- Carotid ultrasound - if possible done prior to clinic appointment
- FBC
- UEC
- Coagulation profile including INR if warfarnised
- Fasting lipids
- Fasting cholesterol
- ECG (? AF) +/- Holter if intermittent palpitations or cardiac risks for paroxysmal AF
Interim/GP management
To refer a patient with this condition, please see the Neurology clinic page for the full referral process and templates.
Add or escalate antiplatelet therapy if there is no evidence of haemorrhage on CT brain.
Instruct patient to attend emergency if develops new symptoms or signs prior to clinic appointment.
Direct link to Health Pathways - TIA page or Stroke page
For more information please see the HealthPathways Tasmania website.
Stroke Foundation Guide for GPs
Clinic appointments
? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Emergency
? Acute stroke - residual neurological signs at time of examination
? Crescendo TIAs
If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.
Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.
Urgent (Category 1)
? All other suspected TIA
We will endeavour to see these patients within two weeks.
Urgent referrals should be accompanied by a phone call, as per below:
- Contact the Neurology Registrar directly within hours via the RHH switchboard Phone: (03) 6166 8308
Routine (Category 3)
Incidental finding of old stroke on cerebral imaging done for other reasons
Next available appointment
Availability
North
Launceston General Hospital
Level 3 - Specialist Clinics
Phone: 1300 977 694
Fax: 03 6777 5227
North West
Unavailable.
South
Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6173 0491
