[Transient cerebral ischemia--precursors of stroke. Can warning signs be recognized?]

Transient ischemic attacks (TIA) are neurological deficits of sudden onset and equally sudden reversal. They are considered to be precursors of stroke that (still) have a good prognosis. Since the symptoms have usually disappeared by the time of the first examination the physician must rely on the information provided by the patient or relatives for the medical history. Symptoms to look for include disordered speech, aphasia, vertigo, unilateral arm paralysis, crooked mouth. When a TIA is suspected, the following examinations are mandatory: neurological ultrasound, blood pressure, ECG, laboratory examinations (blood sugar, blood count, hematocrit), CT or MRI, Doppler-ultrasonography of the carotids and, where indicated, transcranial Doppler. Long-term prophylaxis with platelet antiaggregation agents or Marcumar (phenprocoumon) and appropriate changes in lifestyle are indicated for all TIA patients. When the indication is established, thrombarterectomy must be carried out within six months after the event.