Sxs concerning for re-expression of prior stroke sxs, and notably pt has had more urinary frequency concerning for infection from urinary source though UA neg***. Other infectious sources neg (CXR showed no evidence of PNA, and pt afebrile, no evidence of leukocytosis or other SIRS physiology). No e/o metabolic derangements. However would also consider TIA event, particularly in this higher risk patient with prior stroke hx and moderate ABCD2 score (4)***, despite currently therapeutic on warfarin. Doubt seizure as interactive/conversant throughtout and no witnessed GTC event (would be unusual to have Todd’s paralysis without generalized event). warrant neurology admission for further stroke workup and risk factor stratification.

Chance trial- TIA

In the CHANCE (Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events) trial, a 21-day course of aspirin plus clopidogrel started immediately after a TIA or minor stroke outperformed aspirin alone in reducing the risk for a subsequent stroke, without significantly increasing the risk of major bleeding complications.[3] The hazard ratio for stroke-free survival at 90 days in the combination treatment group was 0.68. Severe bleeding occurred in about 0.2% of patients in both groups.