Table 4

Case scenario 3a
True False Unsure Evidence
n n n
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 [22].
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 [23] 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 [24]. 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

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