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Nonseptic Cerebral Emboli of Cardiac Origin
Gary J. Martin, MD;
José Biller, MD
Arch Intern Med. 1984;144(10):1997-1999.
Abstract
• There Is considerable debate regarding immediate anticoagulation with heparin sodium for patients suspected of having acute cerebral embolism from a cardiac source. We studied 60 consecutive hospitalized patients suspected of having a nonseptic cardiogenic cerebral embolism who, with one exception, were treated with immediate full-dose anticoagulation. None of the patients had progression of their neurologic deficits secondary to intracranial hemorrhage or recurrent embolism, and there were no deaths secondary to anticoagulant therapy. One patient had punctate hemorrhages in the area of infarction, but remained clinically stable. In light of our experience and a review of the literature, we conclude that immediate anticoagulation is judiciously safe in selected patients after nonseptic embolic stroke of cardiac origin, provided early cranial computed tomography fails to demonstrate hemorrhagic infarction.
(Arch intern Med 1984;144:1997-1999)
Author Affiliations
From the Section of Cardiology, Department of Medicine (Dr Martin), and the Department of Neurology (Dr Biller), Loyola University Medical Center, Maywood, Ill. Dr Biller is now with the Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City.
Footnotes
Accepted for publication March 19, 1984.
Reprint requests to Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 (Dr Biller).
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