Stroke, Vol 14, 42-46, Copyright © 1983 by American Heart Association
J Lodder and PJ van der Lugt
We evaluated immediate anticoagulation of embolic stroke. Of 39 patients
suffering a focal cerebral ischemia caused by a cardiac embolus, 38 were
submitted to CT within 24 hours after onset. Twenty- one patients received
direct full anticoagulation and, in 10 patients, treatment was delayed
because of hemorrhagic infarction on initial CT (3 cases), cardiac cause 24
hours or more after stroke onset, or treatment delay without specific
reason (6 cases). Eight patients with severe deficit were not
anticoagulated because of hemorrhagic signs on initial CT, impaired
consciousness, or general contra-indications to such treatment. Twenty-one
follow-up CT-scans were performed under full anti-coagulation, and in only
2 cases hemorrhagic infarction was noticed without clinical deterioration.
No clinical worsening attributable to anticoagulant treatment was observed
during the three week observation period. It is concluded that direct
anticoagulation therapy does neither induce hemorrhagic infarction nor
cerebral hemorrhage in patients with embolic stroke nor does it cause
clinical deterioration.
ARTICLES
Evaluation of the risk of immediate anticoagulant treatment in patients with embolic stroke of cardiac origin
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