Problems of anticoagulant therapy in cerebrovascular disease

Abstract

The problems and complications that arose in the course of anticoagulant therapy in patients with cerebrovascular disease are described in detail. Of 108 patients treated, a total of 22 (20%) had hemorrhagic complications. The incidence of complications was greater (26%) in the group of patients in whom therapy was considered obligatory than in those who were selected as part of the controlled study (16%). A hemorrhagic complication necessitating discontinuance of therapy occurred in only 1 of 18 patients followed for more than 12 months. The older the patient, the greater the incidence of complications; yet 8 patients more than 60 years of age were able to attend clinic for longer than 12 months. Thus, while anticoagulant therapy for cerebrovascular disease is certainly feasible, it involves definite risks and problems. Great care and consideration should be exercised before giving anticoagulants to patients with cerebrovascular disease, and vigilance must be maintained throughout the period of actual therapy.