title: Outpatient management of transient ischaemic attack.
abstract: Stroke is a significant cause of death and disability in Singapore; in 2014, it was the fourth most common cause of death. Transient ischaemic attack (TIA) is defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without evidence of acute infarction. The diagnosis of TIA/acute stroke needs to be considered in all patients who present with sudden focal neurological dysfunction. Prompt referral for assessment, neuroimaging and intervention provides the best chance for neurological recovery and/or minimising further neurological damage. Primary care physicians have a crucial role in TIA/stroke prevention and management. This includes referring patients with suspected acute TIA/stroke to hospitals with stroke treatment facilities immediately; managing the modifiable risk factors of cerebral ischaemia; continuing prescription of antiplatelet agents and/or anticoagulation where indicated; and teaching patients to recognise and respond to suspected cerebral ischaemia using the FAST (face, arm, speech, time) acronym.
authors.affiliation: Division of Family Medicine, University Medicine Cluster, National University Health System, Singapore.
authors.forename: Victor Weng Keong
authors.initials: VW
authors.lastname: Loh
authors.affiliation: Division of Neurology, University Medicine Cluster, National University Health System, Singapore.
authors.forename: Derek Tuck Loong
authors.initials: DT
authors.lastname: Soon
authors.affiliation: Division of Neurology, University Medicine Cluster, National University Health System, Singapore.
authors.forename: Leonard Leong Litt
authors.initials: LL
authors.lastname: Yeo
mesh_terms: D002983:Clinical Competence; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000188:drug therapy; D008487:Medical History Taking; D010045:Outpatients; D010353:Patient Education as Topic; D010960:Plasminogen Activators / Q000627:therapeutic use; D012017:Referral and Consultation; D012307:Risk Factors; D012846:Singapore; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D010960:Plasminogen Activators
keywords: TIA; ischaemic stroke; outpatient