GPAtlas🧭 When to suspect
Suspect a stroke or transient ischaemic attack (TIA) in any patient with the sudden onset of focal neurological symptoms.
• In primary care the duration of those symptoms matters most – not their severity.
• Use a validated screening tool such as FAST (Face, Arm, Speech, Time to call 999).
• Always exclude hypoglycaemia, the classic mimic, in every case.
The key safety message is that a TIA is not a benign event – it is a warning that carries a high early risk of a completed, disabling stroke. Both a stroke and a TIA are medical emergencies.
| Pattern | Defining feature | Immediate action |
|---|---|---|
| Stroke | Focal neurological symptoms still present (even if they began minutes ago) | 999 – immediate transfer to a hyperacute stroke unit |
| TIA | Focal symptoms have fully resolved (usually < 1 hour; by definition < 24 hours) | Aspirin 300 mg + specialist assessment within 24 hours |
Raise suspicion in older patients and in anyone with vascular risk factors – hypertension, diabetes, hyperlipidaemia, smoking, atrial fibrillation, or a previous stroke or TIA.
Source: NICE NG128 · National Clinical Guideline for Stroke
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