A TIA is a warning shot. Symptoms that resolved still need assessing within 24 hours, because the next one may not resolve.
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A stroke happens when the blood supply to part of the brain is cut off, either by a clot or by a bleed. Brain tissue starts dying within minutes, which is why stroke is treated as one of the most time-critical emergencies in medicine.
A transient ischaemic attack — a TIA — produces the same symptoms, but they resolve, usually within an hour and always within 24 hours.
The phrase "mini-stroke" does real harm. It suggests something minor that has passed. What a TIA actually is, is a warning: it means an artery supplying the brain has become unstable, and it identifies someone at substantially raised risk of a full stroke in the days immediately afterwards.
That is why symptoms which have completely resolved still need assessing within 24 hours. The urgency is not about what happened. It is about what happens next, and how much of it is preventable.
A significant minority of strokes do not show face, arm or speech signs, and these are the ones that get to hospital late:
Sudden onset is the common thread. Symptoms that come on over seconds to minutes, rather than gradually, are the ones to act on.
An urgent CT or MRI brain scan is done to distinguish a clot from a bleed, because the treatments are opposite — one is dissolved, the other must not be. That scan is why every stroke goes to hospital rather than anywhere else.
Clot-busting treatment has a narrow time window, and mechanical clot retrieval a somewhat longer one. Every minute of delay costs brain tissue, which is the whole reason for the 999 rule.
Assessment in a specialist TIA clinic within 24 hours, which typically includes:
The ABCD2 score is no longer recommended for deciding who needs urgent assessment after a TIA. Everyone with a suspected TIA needs specialist assessment within 24 hours, regardless of how low-risk they appear. This changed, and the older approach still surfaces.
Migraine with aura, seizures, low blood sugar, and inner-ear causes of vertigo can all resemble a TIA. Distinguishing them is a specialist job — the safe assumption in the moment is stroke.
Stroke and TIA are emergencies. There is no version of this that an online consultation can manage, and we will not pretend otherwise.
If symptoms are happening now, or happened today, stop reading and call 999. If they resolved within the last week, you need to be assessed within 24 hours — contact 111 or your GP today, or attend A&E.
Its role here is entirely before or after the event.
Call 999 immediately — do not wait, do not drive, do not ring the GP — if there is:
Even if the symptoms go away, call 999 while they are happening. You cannot tell a stroke from a TIA at the time — that distinction is only made afterwards, once you know whether it resolved.
You still need specialist assessment within 24 hours. Contact 111 or your GP the same day, or attend A&E. Take a single 300mg aspirin immediately unless you are allergic or have been told not to.
The risk of a full stroke is highest in the first few days after a TIA, and prompt treatment reduces it substantially. This is not a wait-and-see situation.
Do not drive until you have been assessed and told it is safe.
Stroke is the clearest example on this entire website of something where paying privately would actively harm you.
If you are having symptoms, call 999. If you had symptoms that resolved, ring 111 today. Do not book anything with us instead.
This page follows NICE NG128, Stroke and transient ischaemic attack in over 16s: diagnosis and initial management.
NICE NG136 covers hypertension, and NG238 cardiovascular risk assessment and lipid modification. Blood pressure control and anticoagulation in atrial fibrillation — per NICE NG196 — are the two interventions that prevent the most strokes.
Reviewed against NICE NG128, NG136, NG196 and NG238 current at the date shown above.
Yes, urgently — within 24 hours. That is a TIA, and the risk of a full stroke is highest in the first few days afterwards.
Resolution is not reassurance. It is the window in which a stroke can still be prevented.
Because the term is a poor one, and it causes real delay. Nothing about a TIA is minor except its duration.
Treat it as a warning that something is unstable, not as an event that has passed.
Yes — a single 300mg dose immediately after a suspected TIA, unless you are allergic or have been told not to.
This is standard guidance and it is often not known. Then seek assessment the same day.
Often, yes, and this is why the 999 rule exists. Clot-busting treatment and mechanical clot removal both work within defined time windows.
Every minute of delay costs brain tissue. Calling an ambulance rather than driving in gets treatment started sooner.
Not for at least a month after a stroke or TIA, and longer in some cases. The DVLA must be told in certain circumstances.
Check your own position rather than assuming — the rules differ for car and lorry licences.
Migraine with aura can look similar, and distinguishing them is a specialist job.
Migraine aura typically builds over minutes and spreads; stroke symptoms are maximal at onset. If you are unsure, treat it as a stroke.
Yes, and it is worth acting on. That combination raises stroke risk, and the combined pill is contraindicated where aura is present.
Other methods remain available — this is a switch, not the end of contraception.
Outcomes vary enormously, from complete recovery to lasting disability. Speed of treatment is one of the strongest predictors.
Recovery continues for many months, and rehabilitation genuinely changes what that recovery looks like.
Know your blood pressure, and treat it if it is high. Nothing else comes close at a population level.
After that: check your pulse for atrial fibrillation, and stop smoking.
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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