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To characterize the clinical features of patients with acute cerebral infarction who sustained intracerebral hemorrhage related to heparin anticoagulation,we describe 10 patients and review reports of 16 cases. Cardiac-source embolism was identified in seven(70%)of the 10 patients and consisted of atrial fibrillation in six of the seven.The middle cerebral artery and territory was affected in nine patients(90%),with moderate- sized or large infarcts by clinical and computed tomographic criteria.The interval between stroke onset and intracerebral hemorrhage was<72 hours in 80%of the patients.Intracerebral hemorrhage occurred2x control in seven patients.Our findings in the 10 patients are similar to those of the 16 cases previously reported and suggest that heparin-related intracerebral hemorrhage occurs early after stroke onset,usually with moderate-sized or large infarcts,and with excessive anticoagulation in some patients. |
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