[Clinical applicability of the term 'transient neurological attack']

Transient neurological symptoms not fulfilling the criteria for TIA are a problem often encountered in clinical practice. In a large cohort from the Rotterdam study, it was found that these 'transient neurological attacks' (TNA) increase the risk of future cardiovascular events and dementia. However, the group of patients diagnosed with TNA concerns a heterogeneous group with a wide variety of non-focal symptoms. A considerable proportion is probably not caused by vascular (atherothrombotic) disease. Therefore, in our opinion, the reported higher risk for cardiovascular events and dementia should not lead to treatment aimed at secondary prevention in the TNA group as a whole, as it is customary in TIA patients. However, the increased risk for cardiovascular disease, as found in this study, emphasises the need for a thorough search for a possible vascular cause of the symptoms and the presence of cardiovascular risk factors in this complicated group of patients.