Abrupt and dramatic onset of focal neurologic symptoms is typical. Pts may not seek assistance on their own because they are rarely in pain and may lose appreciation that something is wrong (anosognosia). Symptoms reflect the vascular territory involved (Table 17-1). Transient monocular blindness (amaurosis fugax) is a particular form of TIA due to retinal ischemia; pts describe a shade descending over the visual field.