Transient Ischaemic Attack (TIA) And Stroke

Services

Local guideline opens a new window and arrangements for Acute Stroke/TIA assessment

In hours:
Stroke/TIA hotline 0131 536 1019 (Consultant or Senior Registrar)

Out of Hours:
Stroke/TIA Advice: Neurology Registrar via Switchboard
Thrombolysis Advice: Stroke Consultant via Switchboard

Clinics

Monday Afternoon OPD7 RIE
Wednesday Morning OPD7 RIE
Thursday Morning OPD SJH
Friday Morning OPD7 RIE

These clinics offer a specialist assessment with same day CT brain and carotid scanning. We also have urgent access to MRI head, echocardiogram and 5 day ECG monitors. It will not always be possible to offer patients an appointment in their most local hospital.

Communication

A letter will normally be sent within 3 days and will include the final diagnosis and results of investigations.

For all clinics – if the patient is found to have an important abnormality on brain scan or carotid Doppler or unusual test results we will contact them directly by phone. A results letter will be sent to the GP a few weeks after their appointment for tests which are less readily available, e.g. E

Follow up

We do not routinely follow up patients in the Stroke/TIA clinic unless the diagnosis was unclear and needs further clarification or when the patient has recurrent problems.

Life after Stroke Clinic

Thursday Afternoon OPD7 RIE

Referral should be made by e mail to the following address: lifeafterstroke@nhslothian.scot.nhs.uk opens a new window

‘The Life after Stroke clinic’ is suitable for people who have ongoing problems post-stroke or TIA e.g. fatigue, emotional distress, cognitive impairment, of for new problems that develop over time e.g. neuropathic pain, or where the diagnosis is uncertain and requires review.

Community Services for Stroke Patients

The Lothian Managed Clinical Network (MCN) Community Services opens a new window page contains information about the many services available throughout Lothian for both stroke patients and their carers.

One of these services is the Edinburgh Community Stroke Service (ECSS). Details, links to leaflets and referral criteria can all be found nhslothian.scot Stroke-community Pages opens a new window.

Referral Guidelines
Resources and Links

Who to refer:

Minor Stroke
Cerebral TIA (symptoms completely resolved within 24 hours)
Ocular TIA (transient loss of vision within one eye)
Retinal Artery Occlusion (sudden loss of vision in one eye lasting greater than 24 hours)

We are happy to discuss any patient who has had a recent TIA or stroke, not only those who you see during the acute event.

Who not to refer:

Any of the above if they require immediate hospital assessment including suspected thrombolysis- these should be referred via 999 to A&E (no need to call stroke hotline first).
Subarachnoid Haemorrhage – refer to Neurologist/Neurosurgeon.
Patients without symptoms or signs of focal neurological deficits. This is unlikely in a TIA or stroke.
Loss of consciousness. This is very rare in TIAs & minor Strokes.

How to refer:

If you wish to make a referral to this service

First phone the hotline number as outline above to discuss the patient

Then ASAP send a referral via Sci-gateway;

[RIE>GEN MED>LI STROKE TIA]

Information we require:

The proforma indicates those pieces of information which are important for us to know.

We are happy to discuss any patient who has had a recent TIA or stroke, not only those who you see during the acute event.

The specialist will advise on immediate assessment and treatment including admission, or where appropriate, arrange an appointment in the next available Stroke/TIA clinic. Appointment details will be given to the GP at the time of this phone call so you can inform the patient. This will also ensure patients receive immediate treatment before their appointment in the clinic.