Found a malpractice lawsuit stating that it was negligent to admit a TIA patient (symptoms resolved), and that he should have been discharged. Why? Patient has a stroke overnight in the hospital. Neurologist didn't trust the nurse's neuro assessments, so they said no last known normal = no tPA. Patient suffers permanent left side paralysis. Plaintiff attorney says if you weren't going to trust the nurse's assessment, then he should have been discharged home. If he was discharged home, he would have returned to the hospital, and the neurologist would have trusted the patient's self-reported last known normal. Not really the TIA/stroke lawsuit I was expecting, but will certainly raise the issue of if we should even be admitting TIAs (apparently in Canada they do not), and if admitting people to the hospital actually prevents bad outcomes (a narrative that we love to tell ourselves that may not be based in reality).

@medmalreviewer We admit TIAs in Canada with high risk lesion on CTA.

@MicieliA_MD @medmalreviewer Good lord I would hope so. I do think there is small vessel disease that may benefit from aggressive medical management. There is also large vessel stenosis that causes a perfusion deficit warranting intervention. As @TheSGEM said, it all depends!