Abstract T MP74: The Diagnosis, Etiologic Classification, and Safe Discharge of Ischemic Strokes with Transient Symptoms from an Emergency Department Observation Unit

Background: Patients with a clinical diagnosis of transient ischemic attack (TIA) who have imaging evidence of infarction portend a high risk of short-term recurrent stroke. Emergency Department Observation Units (EDOU) offer an alternative to hospital admission and are becoming increasingly utilized for acute cerebrovascular emergencies. Hypothesis: We sought to determine whether an EDOU protocol emphasizing etiologic determination and individualized secondary prevention could be a safe alternative to hospital admission for suspected TIA patients with and without brain infarction. Methods: We prospectively studied 189 patients admitted to the TIA EDOU of a single tertiary care academic medical center. There was no ABCD2 cutoff for eligibility and exclusion criteria included persistent deficits or another diagnosis warranting hospitalization. Patients underwent DW-MRI/MRA of the head and neck unless contraindicated, transthoracic echocardiogram and bedside neurologist evaluation. Etiologic subtyping was d...