Transient ischemic attack (TIA) is a medical emergency, which has been newly 
termed as "acute cerebrovascular syndrome" (ACVS). TIA is often ignored or 
unrecognized by patients or their families since its symptoms are naturally 
subsided without any treatment. TIA is also usually underestimated or 
nonprioritized by physicians because it is regarded merely as a minor stroke. 
However, stroke risk is very high in patients early after TIA. Therefore, rapid 
evaluation followed by immediate treatment is essential in TIA patients. TIA 
patients should be directly referred to stroke specialists in TIA clinics to 
consider hospitalization for specific emergent treatments. Early stroke risk is 
especially high in TIA patients with a high ABCD2 score of 4 or more (A age over 
60 years [1 point]: B blood pressure > 140/90 mmHg [1 point]: C Clinical 
features, including unilateral weakness [2 points] and speech disturbance 
without weakness [1 point] D2: Diabetes [1 point] and Duration of symptoms [1 
point for < 60 min and 2 points for > 60 min]), acute ischemic lesions on 
diffusion weighted image, > 50% carotid stenosis, severe intracranial artery 
stenosis, microembolic signals on transcranial Doppler, atrial fibrillation, or 
hypercoagulable states. It has been reported that immediate starting treatment 
with statins, antiplatelet agents, and antihypertensives substantially reduces 
the risk of stroke within 90 days after TIA. US National Stroke Association 
guidelines recommend assessments using computed tomography (CT)/ CT angiography 
(CTA), magnetic resonance imaging (MRI)/MR angiography (MRA), and carotid 
ultrasonography as well as immediate starting antiplatelet therapy in patients 
with non-cardioembolic TIA or oral anticoagulant therapy in patients with 
cardioembolic TIA within 24 hours during the first week after TIA. A large 
international, multicenter cooperative, observational study (TIA Registry. Org.) 
on 5,000 patients with TIA or minor stroke within 7 days of onset is being 
initiated. Now, we should say "Time is TIA".