Canadian TIA Score
Predicts 7-day risk of stroke after TIA or minor stroke. Guides urgency of investigation and disposition from the emergency department.
How to use & interpret
The Canadian TIA Score estimates the risk of stroke (and related serious events) within 7 days of a transient ischaemic attack, stratifying patients into low, medium and high risk using clinical features, examination and investigations.
It is intended to support — not replace — the standard UK approach of starting antiplatelet therapy and arranging urgent specialist TIA assessment. Unlike the older ABCD², which NICE no longer recommends for triage, it was derived in modern emergency cohorts.
Score interpretation
→ Canadian TIA Low Risk (0–3): <1% 7-day stroke risk. Outpatient neurovascular clinic within 24 hours; start aspirin 300 mg loading then 75 mg; brain imaging (MRI DWI preferred); carotid imaging; ECG; lipid/glucose.
→ Canadian TIA Moderate Risk (4–7): 1–3% 7-day stroke risk. Same-day specialist assessment strongly recommended; MRI DWI; carotid Doppler; continuous cardiac monitoring for AF; aspirin loading; consider admission.
→ Canadian TIA High Risk (≥8): >3% 7-day stroke risk (up to 23% with weakness). Immediate hospital admission; urgent MRI/CT; continuous telemetry for AF; dual antiplatelet therapy (aspirin + clopidogrel for 21 days); carotid imaging; neurology review.
Interpretation bands for the Canadian TIA Score. Apply clinical judgement and local guidance.
Frequently asked questions
Does a low Canadian TIA Score allow me to delay specialist review?
No. UK practice is urgent specialist assessment of suspected TIA within 24 hours; risk scores inform discussion and resource use but should not delay review.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dabigatran (Stroke Prevention — AF) · Direct Oral Anticoagulant — Thrombin Inhibitor
- Rivaroxaban (Stroke Prevention — AF) · Direct Oral Anticoagulant — Factor Xa Inhibitor
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The Canadian TIA Score is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.