Anticoagulants in the prevention of embolic stroke. Part I.

Cardiac lesions among those at high risk of cerebral emboli include: atrial fibrillation, rheumatic mitral valve disease, acute myocardial infarction, prosthetic heart valves, and idiopathic dilated cardiomyopathy. Many of these patients can be protected from cerebral infarction by anticoagulants. Following a cardiac embolic stroke, CT scans are critical in deciding for whom and at what time anticoagulation should be considered. From studies of CT and cerebrovascular pathology, it has become clear that it is the cerebral infarct rather than the arterial occlusion that provides the key piece of information in deciding whether and when anticoagulants should be considered for the secondary prevention of cardiac emboli among patients who present with a clinical stroke.