**Question:** Which one of the following excludes history of transient ischaemic attack?

A. Established history of stroke
B. Known cardiovascular disease
C. Significant risk factors for stroke but no history
D. Recent onset of neurological symptoms

**Core Concept:** Transient Ischaemic Attack (TIA) is a brief episode of neurological dysfunction caused by focal cerebral, spinal, or retinal ischaemia, which resolves within 24 hours. Excluding TIA in a patient's history requires understanding of the clinical presentation, duration, and investigations involved.

**Why the Correct Answer is Right:** Answer C (Significant risk factors for stroke but no history) is the correct choice because it addresses the absence of clinical history. A patient with significant risk factors for stroke, but no history of TIA or stroke, can be considered as having excluded TIA in their history.

**Why Each Wrong Option is Incorrect:**

A. Established history of stroke (patient already has had a stroke)
B. Known cardiovascular disease (this does not specifically exclude TIA)
D. Recent onset of neurological symptoms (TIA typically lasts less than 24 hours, while neurological symptoms in this option indicate a possible stroke)

**Clinical Pearl:** A thorough neurological examination, including assessment of consciousness level, cranial nerve function, motor and sensory function, reflexes, and coordination, helps in ruling out a stroke or TIA. Additionally, investigations like a complete blood count (CBC), blood sugar, lipid profile, and ECG can provide clues to cardiovascular risk factors.

**Correct Answer:** C (Significant risk factors for stroke but no history)