Cardioembolic stroke, early anticoagulation, and brain hemorrhage. Cerebral Embolism Study Group

Arch Intern Med. 1987 Apr;147(4):636-40.


Brain hemorrhage is a feared complication of early anticoagulation therapy in patients with cardioembolic brain infarction. We describe nine patients with cardioembolic stroke who experienced clinical deterioration associated with computed tomography-documented hemorrhagic transformation. The clinical features of these nine patients combined with 15 previously reported cases were analyzed to determine factors associated with hemorrhagic worsening. Patient age, embolic source, and intensity of anticoagulation were not associated with hemorrhagic worsening. Large infarct size and initiation of anticoagulation after early (less than 12 hours) computed tomography were associated with hemorrhagic transformation and clinical worsening in patients who received anticoagulation therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Cerebral Hemorrhage / etiology*
  • Female
  • Humans
  • Intracranial Embolism and Thrombosis / complications*
  • Intracranial Embolism and Thrombosis / diagnostic imaging
  • Intracranial Embolism and Thrombosis / drug therapy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Tomography, X-Ray Computed


  • Anticoagulants