[Management and relapse prophylaxis of cerebral transitory ischemic attack (TIA) (author's transl)]

The paper gives a definition of the clinical concept of TIA, pointing out that the difference between TIA and ischemic brain infarction is not a qualitative but a quantitative one. Anatomy, physiology and metabolism of the brain will be discussed and clinical symptoms of TIA in the supply areas of the carotid and the vertebro-basilar arteries will be presented. Pathogenetic factors of TIA mentioned are: cardiac embolism, intravascular microembolism within the framework of cerebrovascular arteriosclerosis and alterations of blood composition, intracerebral steal mechanism, especially in cases of decreased systemic blood pressure and collateral circulation in stenotic or thrombotic vascular diseases. The paper stresses the importance of early diagnosis of TIA in view of the fact that approx. 30% of TIAs are not only followed by recurrent episodes but also develop into brain infarction. Clarification of the pathogenesis by appropriate examinations and causal therapy are therefore of particular importance. The significance of anticoagulant therapy, platelet aggregation inhibitors and cardiac therapy will be stressed and possible surgical management, especially the surgical bypass, will be presented. The curative and preventive effect of these forms of treatment will be evaluated.