Heparin anticoagulation in acute brain ischemia.

Progressive neurological deterioration in patients with recent stroke or transient ischemic attack (TIA) is a distressing and all too common occurrence. Anticoagulation is an important therapeutic consideration for many of these patients. The use of heparin in patients with acute brain ischemia will be reviewed in this paper. Anticoagulation with heparin is often considered in the following clinical settings: 1) progressing stroke; 2) acute, partial stroke; 3) recent TIA, especially if multiple; and 4) cardioembolic stroke. Anticoagulation is of no value and in fact may be detrimental in completed thrombotic strokes.