ACEP Clinical Policy — TIA and Minor Stroke Evaluation (2016, Updated)

The ACEP Clinical Policy on evaluation of adult emergency department patients with transient ischemic attack (TIA) and minor stroke addresses critical early management decisions including risk stratification for stroke, neuroimaging selection, antiplatelet initiation, and safe hospitalization vs. expedited outpatient management. TIA (formerly 'mini-stroke') is defined by the 2009 AHA/ASA tissue-based definition as a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia WITHOUT acute infarction on MRI. Stroke risk post-TIA peaks within 48 hours of event — the ED encounter is the critical opportunity for secondary prevention.