Not All Patients Should Be Admitted to the Hospital for Observation After a Transient Ischemic Attack

Should this patient be urgently evaluated? Yes, this patient should be evaluated because any transient ischemic attack (TIA), regardless of ABCD2 score,1 may be due to significant arterial stenosis or a cardiac source of embolism that needs to be urgently detected and treated.When? This person should be evaluated within hours after the first call to medical attention because a devastating stroke may quickly follow a TIA. We therefore should be available 24/7. We have shown that this is feasible but needs good organization.2Where? The best setting is the one that is effective. A TIA clinic can be located in the outpatient clinic of the stroke center, in the emergency department, or in a day hospital. In our model, we admit all patients with TIA to a dedicated TIA clinic located at the day hospital, which is a part of our comprehensive stroke center. We then triage patients based on actual findings with the diagnostic tests, not with the ABCD2 score.Which diagnostic tests? In my opinion, MRI should be the preferred …