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Cerebral microbleeds should not preclude anticoagulation

Journal
JAMA Neurology
Reuters Health - 29/10/2020 - The presence of cerebral microbleeds should not be a contraindication to anticoagulation in patients with embolic stroke of undetermined source (ESUS), according to a subgroup analysis of the NAVIGATE ESUS trial. "Patients with embolic stroke of undetermined source who had small occult brain bleeds or 'microbleeds' seen on brain MRI responded similarly to rivaroxaban (compared with aspirin) as patients without microbleeds," Dr. Ashkan Shoamanesh of McMaster University, in Hamilton, Canada, told Reuters Health by email. Cerebral microbleeds (CMBs), present in a third of patients with ischemic stroke, have been associated with recurrent stroke and intracerebral hemorrhage. This association calls into question the safety of anticoagulant therapy in patients with stroke and cerebral microbleeds. Dr. Shoamanesh and colleagues investigated whether microbleeds affected the rates of recurrent stroke or the responses to anticoagulation in...


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