The committee discussed the possible risks of not offering CT brain imaging to everyone with a suspected TIA. They agreed that, in the absence of clinical 'red flag' indicators (for example, headache, anticoagulation, head injury, repetitive stereotyped events), it is rare for a CT scan to reveal an alternative diagnosis needing a different referral pathway. Therefore, the number of referrals to TIA clinics should not increase greatly. In a TIA clinic, not all people will need an MRI. Therefore, clinical assessment by a specialist in a TIA clinic is important for identifying people who may need MRI to determine the vascular territory of ischaemia (the region of the brain with loss of blood flow, supplied by either the anterior or posterior circulation). For example, this could be before a decision is made to refer for a carotid endarterectomy, or to detect alternative pathologies such as tumours, demyelinating disorders or convexity subarachnoid haemorrhage. There was uncertainty about whether urgent, routine MRI screening improves the outcomes for people with suspected TIA, and so the committee made a research recommendation on early MRI brain scanning. How the recommendations might affect practice Not routinely offering CT brain imaging will be a change in practice for some providers (especially in the emergency department), whereas MRI use in the TIA clinic aligns broadly with current practice. The committee was uncertain whether these recommendations will be cost saving overall. It will be a trade-off between a reduction in CT requests against a potential increase in MRI requests. The committee also highlighted that any increase in MRI requests may be small because the decision to perform an MRI will not generally be affected by the results of a previous CT scan. 