Ursula O'Brien 💙

If you see a "TIA" on a patient's PMedHx, be skeptical. Prior to MRI use, clinical events thought to be TIA were in fact minor strokes (up to 30%) MRI is being used as a tool to "rule out ischemia” (if done in a timely fashion < 14 days). MRI negative patients has become a gray zone (some may be TIAs, but most are likely mimics). This is where neurological assessment adds value, helping distinguish TIA from its mimics and manage diagnostic uncertainty by establishing the pre-test probability of cerebral ischemia. Incorrectly labelling a spell as a TIA can lead to unnecessary long-term treatment with ASA and statin, exposing patients to potential risks without a clear indication.