Transient ischemic attacks and ischemic stroke: indications for anticoagulation.

Abstract

The value of anticoagulant therapy in cerebrovascular disease has not been adequately documented. Until the results of well-designed trials are available, physicians must use these agents on the basis of personal experience, anecdotal reports, and uncontrolled series. We use anticoagulants in selected patients to (1) prevent recurrent cardioembolic stroke, (2) stem the progression of atherothrombotic stroke in progress, and (3) prevent stroke in patients presenting with a series of transient ischemic attacks. Given the improved status of anticoagulants in cerebrovascular disease, it is essential to rule out contraindications or nonthrombotic causes of patient deterioration before they are administered.