[Management of transient ischemic attack]

A transient ischemic attack (TIA) is a medical emergency due to the high early stroke risk, peaking within 48 hours. Diagnosis is exclusively clinical. The challenge lies in excluding mimics while avoiding the over-exclusion of atypical presentations, which carry a comparable stroke risk and require equal urgency. Management relies on rapid assessment (imaging, etiological workup) and immediate, mechanism-oriented secondary prevention. Short-term dual antiplatelet therapy is recommended for non-cardioembolic TIAs at high risk of recurrence. Intensive blood pressure and lipid-lowering therapies are essential. This article proposes a pragmatic management pathway based on current international guidelines.