A patient with a previous TIA or stroke has an increased risk of subsequent stroke, although other risk factors for stroke among these individuals are less clear.7 The risk of stroke associated with a prior TIA or stroke can be reduced with appropriate treatment. Individuals who suffer a cardioembolic TIA or stroke are generally treated with oral anticoagulants (warfarin) to prevent a recurrence.4 Patients whose first TIA or stroke is due to another cause are candidates for antiplatelet therapy.4 For patients with symptomatic carotid stenosis greater than 50%, carotid endarterectomy may be indicated in addition to antiplatelet therapy.13 Options for stroke prevention before or after a first TIA or stroke include drug therapy, surgery, and lifestyle changes. The drugs used are (1) antiplatelet agents (aspirin, ticlopidine, clopidogrel, dipyridamole, and aspirin plus extended-release dipyridamole), (2) oral anticoagulants (warfarin), (3) cholesterol-lowering drugs (hepatic hydroxymethyl glutaryl coenzyme A–reductase inhibitors ["statin" drugs]), and (4) antihypertensive agents (diuretics, angiotensin-converting enzyme inhibitors, β-blockers, calcium channel blockers, and α-blockers). The surgical treatment is carotid endarterectomy; and lifestyle changes include smoking cessation, moderation in alcohol consumption, appropriate physical activity, and weight reduction. This list is continually expanding as our understanding of the underlying causes of stroke increases.