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Reassessment of Anticoagulant Therapy in Various Types of Occlusive Cerebrovascular Disease

Precise use of categorical terms and definitions is mandatory in discussing the use of anticoagulants in treating occlusive cerebrovascular disease. The components of the temporal profile of the disease are described. Six reports have appeared which describe the results of anticagulant therapy in transient cerebral ischemic attacks. From these six studies it is concluded that anticoagulant therapy significantly decreased the risk of cerebral infarction in patients who had attacks of transient focal cerebral ischemia. In the few carefully performed investigations of the use of anticoagulant for acute progressing stroke the evidence points to the lack of progression in patients receiving treatment when compared to individuals not getting such drugs. There continues to be a definite difference of opinion about the results of anticoagulant therapy in completed stroke. If anticoagulant is to be administered on a long-term basis, it must be considered dangerous and every effort made to control the level of anticoagulant action precisely. Hypertension must be effectively controlled.