Transient Ischemic Attack (TIA): Stroke Warning Sign, Risk Timeline, and Prevention

Definition

Transient (<24 h, typically <1 h) focal neurological deficit from temporary cerebral ischemia without acute infarction on imaging.

Stroke Risk After TIA

Timeframe	Risk
48 hours	4–10%
7 days	8–12%
90 days	10–20%
1 year	15–25%
5 years	25–30%

Immediate Management (ABCD² Score ≥4 → Admit)

• Urgent brain MRI/DWI (gold standard).
• Carotid imaging (US/CTA/MRA).
• Cardiac monitoring (AF detection).
• Labs: CBC, glucose, lipids, renal, coagulation.
• Start antiplatelet (aspirin 160–325 mg load → 81 mg daily) ± clopidogrel 21 days (CHANCE/POINT protocol).
• Statin high-intensity; BP <130/80.

Lifestyle

• Smoking cessation, Mediterranean diet, 150 min/week moderate exercise.