How do you determine the timing of anticoagulation for patients with large MCA strokes secondary to atrial fibrillation?

Timing for anticoagulation initiation depends on the size of the stroke and whether a thrombus is present outside the cerebral vasculature. In general, between 4-14 days is standard practice, with early initiation in smaller strokes (to prevent recurrent stroke) and later in larger strokes (to prevent hemorrhagic transformation). Yaghi et al., PMID 32757753