Lessons to be learned in intracerebral haemorrhage research

Abstract

Patients with atrial fibrillation who survive an intracerebral haemorrhage are at increased risk of subsequent ischaemic stroke. Specifically, the annual risk ranges between 1% and 12·7% without anticoagulation and between 0·8% and 5·6% with anticoagulation.1 To date, randomised trials investigating the safety and efficacy of anticoagulants have included only patients without recent intracerebral haemorrhage. The 2020 guidelines of the European Society of Cardiology recommend that the decision to start or restart oral anticoagulation in patients with atrial fibrillation after an intracerebral haemorrhage should be considered in consultation with a neurologist or stroke specialist.