NNT approximately 46 to prevent one stroke over 5 years
Benefit present regardless of baseline LDL
Patient Discharge Instructions
copy discharge instructions
What happened to you
You had a transient ischemic attack (TIA) — also called a mini-stroke
Your brain briefly did not get enough blood flow
Symptoms resolved completely, but a TIA is a warning sign
The risk of a full stroke is highest in the first 48 hours after a TIA
Your medications and follow-up appointments are critical
Do not ignore any new or returning symptoms
Your medications — take exactly as prescribed
Antiplatelet medication (aspirin, clopidogrel, or both)
Do not stop taking these without speaking to your doctor
Take at the same time each day
Blood pressure medications
Take every day even if you feel well
Check your blood pressure at home daily if possible
Cholesterol medication (statin)
Take as directed — reduces your risk of future stroke
Report muscle pain or weakness to your doctor
Call 911 immediately if you develop any of these symptoms
Any new weakness, numbness, or facial droop
One side of face, arm, or leg
New difficulty speaking or understanding speech
Sudden vision loss in one or both eyes
Severe headache unlike any you have had before
Sudden loss of balance or inability to walk
Any symptom that does not resolve within minutes
Follow-up appointments — do not miss these
Neurology or TIA clinic within 48 hours
No later than 1 week from today
Bring your medication list
Primary care within 1–2 weeks for ongoing risk factor management
Blood pressure and cholesterol check
If outpatient MRI or echocardiogram was ordered — attend these appointments
These tests help identify the cause of your TIA
Lifestyle changes starting today
Stop smoking — seek help from your doctor if needed
Eat a Mediterranean-style diet — fruits, vegetables, fish, olive oil
Reduce salt intake
Limit alcohol to 1–2 drinks per day maximum
Regular walking or light exercise as tolerated
Driving and safety
Do not drive until cleared by your neurologist or physician
Laws regarding driving after TIA vary by jurisdiction
Most physicians advise no driving for at least 1 month
Avoid operating heavy machinery or working at heights until cleared
Expected recovery
Symptoms of TIA should be fully resolved
Focus is on preventing a future stroke, not recovering from current episode
You may feel anxious or worried — this is normal
Speak with your doctor if anxiety or depression symptoms develop
References
Guidelines and key sources
Primary societal guidelines
AHA/ASA 2023 Scientific Statement: Diagnosis, Workup, Risk Reduction of TIA in the Emergency Department Setting — Amin HP et al., Stroke 2023
ACEP endorsed framework for ED-based TIA evaluation
Recommends vascular imaging regardless of ABCD2 score
AHA/ASA 2021 Guideline for Prevention of Stroke in Patients with Stroke and TIA — Kleindorfer DO et al., Stroke 2021
Antiplatelet regimens, BP targets, statin goals, lifestyle recommendations
DAPT 21 days for high-risk TIA, long-term DAPT not recommended
ACEP Clinical Policy 2016: Critical Issues in the Evaluation of Adult Patients with Suspected TIA in the ED — Lo BM et al., Annals of Emergency Medicine 2016
Level B recommendation for vascular imaging regardless of ABCD2
Level B recommendation for 12-lead ECG on all patients
Key clinical trials and meta-analyses
CHANCE Trial — aspirin plus clopidogrel vs aspirin alone for high-risk TIA in Chinese patients
DAPT reduced 90-day stroke risk by 32%
Wang Y et al., NEJM 2013
POINT Trial — aspirin plus clopidogrel vs aspirin for early high-risk TIA and minor stroke
DAPT reduced 90-day major ischemic event by 25%
Johnston SC et al., NEJM 2018
THALES Trial — aspirin plus ticagrelor vs aspirin for acute TIA and minor stroke
Reduced 30-day stroke or death; higher bleeding rate
Johnston SC et al., NEJM 2020
SPARCL Trial — high-dose atorvastatin post-TIA and stroke
Atorvastatin 80 mg reduced stroke by 16% vs placebo
Amarenco P et al., NEJM 2006
ABCD2 Score meta-analysis — Sanders LM et al., Neurology 2012
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.