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TIA Secondary Prevention — SCE Neurology MCQ

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ModerateNeurologyTIA Secondary PreventionSCE Neurology

A 66-year-old woman had a high-risk TIA 2 days ago (ABCD² score 5). Imaging excludes hemorrhage; no cardioembolic source is found. What antithrombotic regimen is recommended now?

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Correct answer: C — Dual antiplatelet therapy for 21 days then single agent

For minor ischemic stroke or high-risk TIA without cardioembolism, early dual antiplatelet therapy (aspirin + clopidogrel) for 21 days reduces early recurrence, then transition to a single agent. Monotherapy alone is inferior early; anticoagulation is not indicated without AF or another cardioembolic source; deferring therapy is unsafe.

Reference: AHA/ASA Guideline (2021): Stroke Prevention in Patients With Stroke and TIA