[Assessment and diagnosis of transient ischemic attacks]

Transient ischemic attacks (TIA) are defined as acute, retinal or focal-cerebral neurological symptoms, resulting from vascular disease, which resolve in less than 24 hours. Typical clinical signs are transient visual obscuration, sudden weakness of one arm or leg, loss of speech, and dizzy spells. These patients run a considerable risk of stroke; hence rapid diagnosis and treatment are mandatory. Differential diagnosis includes transient global cerebral function loss, non-vascular transient focal attacks, as well as extracerebral causes of transient neurological symptoms. The following basic investigations are necessary for most patients with TIA: simple laboratory work-up, extra- and transcranial doppler/duplex-ultrasonography, cardiological examination and CT-scan. Angiography and MR-angiography are reserved for specific questions.