[Increased risk of stroke after TIA. New data support the need of urgent management]

The prognosis after TIA may be more serious than previously thought. Recent studies suggest that the risk of subsequent stroke after a TIA may be 5% within the first two days after a TIA, which emphasizes the need for urgent management and institution of therapy. A correct diagnosis is essential, but sometimes difficult because many conditions mimic TIA symptoms. Routine diagnostic procedures include a careful patient history, neurological examination, EKG, CT scan of the brain, and in selected cases carotid and cardiac ultrasound examinations. A recent survey of clinical management after TIA indicates that these investigations are sometimes delayed, particularly in non-hospitalized patients. Patients with a new TIA should immediately be referred to hospital, and ultrasound examination of the carotid arteries (when indicated) should be performed within one week (preferably even earlier) after the TIA onset.