Direct to an emergency department for:

  • Transient ischaemic attack(s) in last 48 hours
  • Multiple or recurrent transient ischaemic attack episodes in the last seven days
  • Amaurosis fugax in last 48 hours
  • Persistent neurological deficit.

Immediately contact the neurology registrar to arrange an urgent neurology assessment for:

  • Transient ischaemic attack(s) that has occurred more than 48 hours ago and within the last two weeks.

Criteria for referral to public hospital specialist clinic services

  • Internal carotid stenosis (> 50%) on imaging with symptoms (excluding dizziness alone), more than two weeks after onset of symptoms
  • Asymptomatic internal carotid stenosis > 70% on imaging
  • An old stroke identified on imaging that has not been previously addressed.

Information to be included in the referral

Information that must be provided

  • Timing and severity of symptoms
  • Neuroimaging results
  • Vascular imaging results
  • Current and complete medication history (including non-prescription medicines, herbs and supplements).

Provide if available

  • Full blood examination
  • Liver function tests
  • Fasting blood glucose level
  • Fasting lipid profile
  • Any echocardiogram or Holter monitor results
  • International normalised ration (INR) > 1.5 in patients taking an anticoagulant medicine.
  • If symptoms are thought to be linked to probable or confirmed SARS CoV-2 (COVID-19) infection or Long COVID.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

  • An old stroke identified on imaging that has been previously addressed
  • Age appropriate, asymptomatic deep white matter disease or T2-hyperintense lesions
  • Chronic vascular risk factors without an acute transient ischaemic attack or stroke
  • Primary prevention of vascular risk.