When do you start anticoagulation in a patient with cardioembolic CVA secondary to new onset atrial fibrillation with hemorrhagic conversion?

Those are great questions and there is no right answer. My general practice is to delay anticoagulation beyond the standard 3-14 days initiation period when there is hemorrhage. I would wait longer if the hemorrhage is parenchymal as opposed to petechial but in both cases, I performed follow up scans to ensure resolution of the hemorrhage prior to initiation of anticoagulation. I am sorry there is no perfect answer as we have limited data on this, pending ongoing randomized trials. Note that the...