|Case scenario 3a|
|1.A repeat CT scan in 7 days should be performed||6||11||15||Whilst diagnosis of a TIA is a clinical one, the use of imaging enables clinicians to confirm ischaemia, exclude haemorrhage or any other pathology mimicking a stroke. A CT scan after 8–10 days however, is less sensitive to haemorrhage and an MRI may be the more appropriate investigation .|
|2.Carotid duplex need not be done as symptoms were not in the carotid territory||5||25||2||As ‘best clinical practice’ the National Stroke Foundation  recommends that patients with carotid territory symptoms who would be candidates for surgery have a carotid duplex ultrasound. However, the reliability in determining the correct vascular territory clinically is only moderate in neurologists . Bloods should be obtained routinely in all patients for a full blood picture, electrolytes, renal function, fasting lipids, erythrocyte sedimentation rate and/or C-reactive protein and glucose. An ECG should be performed in all patients, with attention to the presence of atrial fibrilliation (AF).|
|3.Bloods should be taken for FBE, ESR, BGL, lipids,UEC||31||1||0|
|4.ECG not needed as PR is regular||2||28||2|
Mrs FH is a 58 year old lady who is discharged from the hospital Emergency Department yesterday following a TIA with symptoms of vertigo and ataxia, which have completely resolved. She presents to you for follow up having had a normal CT brain in the Emergency Department but no other investigations.
Leung et al.
Leung et al. BMC Research Notes 2012 5:278 doi:10.1186/1756-0500-5-278