When symptoms resolve within 24 hours but diffusion-weighted MRI shows acute infarction, the event is a stroke under the tissue-based definition used in current guidance and ICD-11. These patients carry a higher early recurrence risk than those with a negative scan. Investigate and start secondary prevention urgently, as for any minor stroke, and record the imaging finding clearly so the diagnosis is not later downgraded to TIA. Driving and work advice should follow stroke rules.
- Record the DWI finding explicitly in the discharge summary.
- Start antiplatelet, statin and risk-factor treatment urgently.
- Complete vascular and cardiac work-up as for minor stroke.
- Give driving advice according to stroke, not TIA, rules.
Why it matters
Labelling these events as TIA can lead to lighter follow-up than the risk warrants.
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