When should I seek immediate help if I've had a transient ischemic attack?

As many as 10% to 20% of people who have a transient ischemic attack (TIA), will suffer a full-blown stroke within 90 days, with the greatest risk in the first week. That's why it's so important to seek medical help promptly because the fact that symptoms have disappeared does not mean that the danger is over.

A study in The Lancet underscored the importance of prompt treatment of TIA. In the study, patients who were promptly diagnosed and began preventive treatments (drugs to prevent clotting and to lower blood pressure and cholesterol) within one day of a TIA were 80% less likely to have a stroke within the next 90 days as patients who did not start preventive treatments until three weeks after a TIA.

The American Heart Association and American Stroke Association (AHA/ASA) stroke guidelines, which provide direction for physicians throughout the nation, reflect the urgent need to determine the cause of a TIA so that damage can be minimized. The AHA/ASA consensus is that someone with a TIA should be evaluated with MRI within 24 hours and hospitalized if found to be at high risk for an impending stroke.