title: Anticoagulation therapy is harmful to large-sized cerebellar infarction.
abstract: OBJECTIVE
  Anticoagulants are commonly used to treat ischemic stroke. Its impact on cerebellar infarction has not been fully understood.
  
  
  METHODS
  In the clinical study, we reviewed a consecutive series of patients with large-sized cerebellar infarction (diameter > 3 cm, n = 30) treated with or without anticoagulation. In animal study, cerebellar infarction operation was performed in 12 Cynomolgus monkeys. Then the animals were administrated with low molecular weight heparin (LMWH) or vehicle for 14 days.
  
  
  RESULTS
  Six patients died during the following treatment. All the subjects that died received anticoagulation therapy, while nobody in the survival group received such a therapy. Compared with sham-operated animals, all monkeys with cerebellar infarction have obvious neurological deficits. The number and size of the Purkinje cells in the cerebellar area were also reduced. Two animals in the LMWH group (33%) died, while all animals in the vehicle control group survived. Compared with the vehicle group, the neurological score in the LMWH group was significantly increased (P < 0.05). The water content in the cerebella was also significantly higher (P < 0.05). Edema, hemorrhage, and subarachnoid hemorrhage occurred in the cerebella as well as brainstem of all the LMWH treated animals.
  
  
  CONCLUSIONS
  These results indicated the harmful effects of anticoagulation therapy on large-sized cerebellar infarction.
authors: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors: She-Qing
authors: SQ
authors: Zhang
authors: Wei
authors: W
authors: Wang
authors: Xiao-Long
authors: XL
authors: Ma
authors: Yu-Ye
authors: YY
authors: Xia
authors: Ai-Jun
authors: AJ
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects*; D001929:Brain Edema / Q000139:chemically induced; D020520:Brain Infarction / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D005260:Female; D006801:Humans; D008252:Macaca fascicularis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D013997:Time Factors
chemical_list: D000925:Anticoagulants
keywords: Anti-coagulation therapy; Cerebellar infarction; Hemorrhagic transformation; Low-molecular weight heparin