Modern TIA management reflects in many ways the management of acute coronary syndrome. Good evidence exists that the sooner investigation and secondary prevention are instituted, the lower the risk of subsequent disabling stroke. This effect is seen even within the first 48 hours.
The ABCD scoring system is a means of assigning relative risk of subsequent stroke on a clinical basis and to determine the degree of urgency for further action. Patients with neurologic abnormalities lasting longer than 3 hours will have already had CT to determine eligibility for thrombolysis. The remainder will receive an ABCD score which will help to determine whether investigation and possible secondary prevention should be emergent or urgent (within 48 hours if possible). There is no longer any case to be made for delayed or elective action following a suspected TIA.