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Although transient ischemic attack (TIA) is a common diagnosis in the emergency department, and 10% to 30% of patients progress to stroke if TIA is not diagnosed and treated, admission criteria and the extent of ED evaluation and treatment vary widely. In a prospective randomized trial, researchers compared usual inpatient work-up to use of an accelerated diagnostic protocol in an ED observation unit.
The researchers enrolled 151 patients who presented to a single ED with TIA, no known embolic source, normal computed tomography scan, normal neurologic exam or abnormal findings that were improving, no history of large stroke, and no alteration in consciousness. The ED observation protocol was similar to the inpatient work-up and included basi…