What are the key clinical features that differentiate a TIA from a stroke in a primary care setting?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

In a primary care setting, the key clinical feature differentiating a transient ischaemic attack (TIA) from a stroke is the duration and resolution of neurological symptoms .

Both conditions present with sudden onset neurological symptoms . A validated tool such as FAST (Face Arm Speech Test) should be used outside hospital to screen people with sudden onset neurological symptoms for a diagnosis of either stroke or TIA . Hypoglycaemia should be excluded as a cause of these symptoms .

A TIA is suggested when neurological symptoms have resolved . Conversely, if a person has ongoing focal neurological deficits, even if they had a negative FAST test, they must be managed as an acute stroke rather than a TIA .

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