Strokes

It is not clear from your question which type of stroke your father had – ischemic (infarct) or hemorrhagic (bleeding). Why they gave him tPA and what happened after that?


Brain infarcts (85%) happen more often than brain bleeding (15%). Brain infarcts occur when thrombosis happens in a brain artery or a thrombus, created outside the brain (embolus), sticks in a brain artery. People with atrial fibrillation (like your father) are susceptible to develop brain infarcts because a lot of blood clots are created in a heart with atrial fibrillation.


Anticoagulant therapy (including Coumadin) is used for treating and further prevention of ischemic strokes. Anticoagulant therapy mustn’t be used in case of hemorrhagic stroke because it can worsen the condition. After the acute phase of hemorrhagic stroke, anticoagulants can be given but with great caution. One year after hemorrhagic stroke I don’t see a reason not to give Coumadin especially when your father still has atrial fibrillation plus deep vein thrombosis (DVT). Basically, hemorrhagic strokes are not due to blood’s decreased coagulation ability but to high blood pressure or brain artery aneurism (weak vessel wall).


Lipitor can be given anyway if your father has increased blood cholesterol.


You may want to consult a neurologist and transfusiologist about this problem.