Thirty-four patients with transient ischemic attacks (TIA) have been followed for 1 to 24 months. Twenty-two patients had TIA in the anterior and 12 in the posterior circulation. Episodic and late onset vascular headaches occurred. Four patients had episodic headaches, 7 patients had late onset vascular headaches and 11 patients had both types of headaches. Episodic headaches preceded, occurred during, or immediately after TIA. These headaches were present in 15 of the patients (44%). Late onset vascular headaches started in middle or late life, occurred independently of TIA and were observed in 18 patients (52.9%). In 13 patients the headaches began 1 month to 15 years prior to TIA and in 5 cases, 2 days to 1year after the onset of TIA. Late onset vascular headaches preceded TIA in 38.2% of patients. These headaches might be of prognostic significance in some patients for the development of TIA and stroke.