Management of transient cerebral ischaemic attacks by hospital doctors in Scotland

A postal survey was carried out by questionnaire in Scotland among hospital clinicians considered most likely to see patients with transient cerebral ischaemic attacks. Of 650 questionnaires dispatched, 268 (41 per cent) were completed and returned. This survey indicates that the majority of clinicians dealing with this problem are confused by the controversial data and management guidelines available in the literature. Over 50 per cent of the respondents were either dubious or unaware of the benefits of any of the three current methods of treatment: anticoagulation, platelet-modifying drugs and carotid artery surgery. Yet 87 per cent of the clinicians were using low-dose aspirin (less than 600 mg/day) irrespective of the patient's sex, often in combination with other platelet-modifying drugs. Anticoagulation and carotid artery surgery were used as alternative treatments by only a third of the respondents in fewer than a third of their patients. The risks of anticoagulation and carotid artery surgery were thought to be high and often unacceptable, but aspirin therapy was considered to be the safest.