19th July 2023

Management

Aspirin 300mg should be given immediately to those presenting with a suspected TIA.

NICE then recommends urgent referral to a specialist for further assessment within 24 hours of presentation. In addition to this, the RCP guidelines recommend that those who have had a suspected TIA more than a week ago should be referred to be assessed by a specialist within 7 days.

The ABCD² scoring system should no longer be used to guide the urgency of referral.

Once a TIA has been confirmed following specialist assessment, the Royal College of Physicians national guidance recommends loading with 300mg clopidogrel with 75mg clopidogrel daily thereafter.

Secondary prevention measures should also be started at the earliest opportunity. The principles of secondary prevention are the same as those in stroke.