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Evidence to Improve Care

Is Transient Ischemic Attack a Medical Emergency?

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee recommends that patients presenting with a transient ischemic attack with high-risk features or a minor stroke undergo a brain CT scan and initiation of antiplatelet therapy (provided this is not contraindicated) as soon as possible and no later than 24 hours after symptom onset, followed by other stroke prevention treatments tailored to each patient.

Read the full OHTAC Recommendation

A transient ischemic attack is a brief interruption of the blood supply to part of the brain. Symptoms are similar to a stroke: confusion, difficulty talking or seeing, dizziness, loss of balance, or sudden weakness or numbness on one side of the body. Many people do not seek medical help because the symptoms do not last long. But a transient ischemic attack can be a warning sign of a stroke in the very near future, with the risk of permanent damage or death.

Health Quality Ontario Reviews Rapid Access to Care for Transient Ischemic Attack

Quickly assessing and treating someone who has had a transient ischemic attack is important to reduce his or her risk of stroke. Specialized clinics can provide this rapid care.

Is Transient Ischemic Attack a Medical Emergency? An Evidence-Based Analysis (PDF)
February 2015

Cost-Effectiveness of Urgent Care for Transient Ischemic Attack: An Economic Rapid Review (PDF)
February 2015

Transient Ischemic Attack: Where Can Patients Receive Optimal Care? A Rapid Review (PDF)
January 2015

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The Ministry of Health and Long-Term Care endorses these recommendations.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with these recommendations and encourages health care professionals to adhere to them. The recommendations are included in the Ministry’s and Health Quality Ontario's Clinical Handbook for Stroke, which is a funded quality-based procedure. The Ministry provides funding to Local Health Integration Networks and hospitals to best organize other aspects of stroke care according to the needs of their unique populations.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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