title: Transient ischaemic attack clinics and management of transient ischaemic attacks.
abstract: OBJECTIVE
  The aim is to review transient ischaemic attack (TIA) clinics, other service delivery models, and current TIA management.
  
  
  RESULTS
  Urgent assessment of TIA patients by stroke specialist services reduces stroke risk and is cost-effective. Almost one-third of TIA patients wait more than 24 h before presenting to medical attention, with delay associated with higher stroke risk. Risk stratification following suspected TIA may be performed by clinical assessment of individual patient characteristics, combined with the validated ABCD2 score (pre-investigation), and the ABCD3-I score (postinvestigation) in secondary care settings. Brain MRI and transcranial Doppler ultrasound add information related to vascular territory, TIA mechanism, and prognosis. Variability in systolic blood pressure in treated and untreated patients is an important predictor of stroke risk, independently of mean blood pressure.
  
  
  CONCLUSIONS
  Daily specialist-provided TIA services delivered in clinic or inpatient settings have proven efficacy for stroke prevention. In addition, a rapid-access, clinic-based service is associated with cost savings and reduced hospital bed-day utilization after TIA.
authors.affiliation: Mater University Hospital, University College Dublin/Dublin Academic Medical Centre, Dublin, Ireland.
authors.forename: Aine
authors.initials: A
authors.lastname: Merwick
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kelly
mesh_terms: D000554:Ambulatory Care Facilities; D016893:Carotid Stenosis / Q000628:therapy; D003362:Cost-Benefit Analysis; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000628:therapy; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors