Stroke and transient ischaemic attack in over 16s: diagnosis and initial management NICE CKS

Question 1

TIA test/ diagnosis

Answer 1

• FAST (Face Arm Speech Test)
• ROSIER (Recognition of Stroke in the Emergency Room)
  ^ tools

Question 2

Initial management of confirmed TIA

Answer 2

1. Aspirin (300 mg daily) STAT - ORAL if no dyspepsia or rectally or enteral tube if dyspepsia, consider PPI FOR 2 WEEKS OR alternative antiplatelet agent.

• Assessment/Investigation ABCD2 scoring system not useful - no CT scans MRI = best

2. • Secondary prevention alongside aspirin once confirmed

IV Alteplase (Thrombolysis) - ASAP at least 4.5 hours os S IF intracranial haemorrhage has been excluded. - TRAINED STAFF NEED TO ADMIN (nursing staff trained in acute stroke and thrombolysis to provide level 1 and
Level 2 care )

3. Thrombectomy - surgical removal of a blood clot - within 6 hours of symptom onset