Protecting the Brain, From the Heart: Safely Mitigating the Consequences of Thrombosis in Intracerebral Hemorrhage Survivors With Atrial Fibrillation

Stroke. 2022 Jul;53(7):2152-2160. doi: 10.1161/STROKEAHA.122.036888. Epub 2022 Jun 27.

Abstract

Optimal antithrombotic management after intracerebral hemorrhage remains one of the central unresolved issues for patients who survive, especially for those patients with atrial fibrillation. Given the observational nature of the studies regarding anticoagulation resumption after intracerebral hemorrhage, there is uncertainty regarding resumption of oral anticoagulation therapy and its timing. There is limited high-quality evidence to guide clinical practice, leading to significant practice variation and uncertainty for patients and providers. Here, we aim to provide the key elements to guide clinicians in their individual decision: whether or not to start or resume anticoagulation in patients with a history of intracerebral hemorrhage.

Keywords: anticoagulation; atrial fibrillation; cerebral hemorrhage; left appendage closure.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / drug therapy
  • Brain
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / drug therapy
  • Humans
  • Stroke* / complications
  • Stroke* / drug therapy
  • Survivors
  • Thrombosis*

Substances

  • Anticoagulants