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There is no doubt that progress has been made in the care of patients with transient ischaemic attack (TIA) over recent years. Virtually all hospitals now offer rapid access neurovascular clinics or admission for high risk patients with many units running clinics 7 days a week. Availability of brain and carotid imaging has improved1 and the UK Carotid Interventions Audit has shown dramatic improvements in the symptom to surgery times coming down from a median of 28 days in 2008 to 21 days in 2010 and 14 days in 2012.2 However, in this edition of the journal Lager et al report the results of a study examining how effectively risk factors are managed in primary care in the UK after a diagnosis of TIA has been made in a specialist clinic.3 The key message is that substantial improvements are needed if we are to minimise the risk of further cerebrovascular disease in all patients. And it is worth pointing out that it is not just stroke that can be avoided but vascular dementia, ischaemic heart disease and peripheral vascular disease as well. There is no shortage of good papers and policy documents that define the standards that we should be achieving.4–6 We know that the …
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