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. 2016 Dec;57(12):658-663.
doi: 10.11622/smedj.2016180.

Outpatient management of transient ischaemic attack

Victor Weng Keong Loh  1 , Derek Tuck Loong Soon  2 , Leonard Leong Litt Yeo  2
Affiliations

Outpatient management of transient ischaemic attack

Victor Weng Keong Loh et al. Singapore Med J. 2016 Dec.

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.

Keywords: TIA; ischaemic stroke; outpatient.

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Figures

Box 1
Box 1
The FAST mnemonic for recognising stroke:
Box 2
Box 2
Stroke chain of survival:
See this image and copyright information in PMC

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