Response by Rollins and Dowling to Letter Regarding Article, “Dynamic Arterial Compression in Pediatric Vertebral Arterial Dissection”
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We thank Drs Yu and Liu for their interest in our article.1 With respect to their query about the use of systemic anticoagulation, we have several points. In the International Stroke Trial in adults, patients given heparin were shown to have significantly fewer recurrent ischemic strokes within 2 weeks. However, this benefit was completely offset by a similar-sized increase in hemorrhagic stroke, and thus, heparin is not recommended for the treatment of ischemic stroke in adults.2 However, the risk factors for hemorrhagic conversion, including advanced …