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Stroke/transient ischaemic attack (TIA)

Stroke/transient ischaemic attack (TIA)

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Acute neurological symptoms of a stroke; multiple/crescendo TIA
  • New acute symptoms of stroke/transient ischaemic attack (TIA)
  • Patients with acute neurological symptoms of a stroke within the past 7 days

Immediately contact on-call registrar or service to arrange an immediate neurology assessment (seen within 7 days) for:

  • Nil

To contact relevant service, please see HealthPathways: Acute Neurology Assessment

Presenting issues
  • Internal carotid stenosis (> 50%) with ongoing symptoms other than dizziness
  • Asymptomatic internal carotid stenosis > 70% on imaging
  • An old stroke identified on imaging that has not been previously addressed
Mandatory referral information (referral will be returned if this information is not included)

History

  • Relevant history, onset and duration of symptoms including
    • Evolution of symptoms
  • Current medication list
  • Relevant past medical history
  • Degree of functional impairment (e.g. impact on mobility/falls/employment/ADLs/weight loss/carer information)

Examination

  • Physical examination findings

Investigations

  • Doppler ultrasound carotid vessels
  • Neuroimaging results
  • ECG

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to attach mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information

  • LFTs
  • FBC
  • Fasting lipids
  • BGL
  • Echocardiogram
  • Holter monitor results
  • ABCD2 stroke risk score
  • Discharge summary (if the patient is being referred for second opinion)
  • Indicate whether the patient has previously attended a neurology clinic or seen a neurologist
    • If so please attach contact details, dates and any other information and correspondence relating to these visits
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • No category 1 criteria
Category 2
Appointment within 90 days
  • Stroke/TIA known or suspected with last change in symptoms more than 2 weeks prior to referral
Category 3
Appointment within 365 days
  • Chronic ischaemic lesion identified on imaging not previously addressed
Last reviewed: 29-06-2023

More information

Email: DOHSpecialistRAC@health.wa.gov.au

wa.gov.au