Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), inconsistency (heterogeneity in treatments) and imprecise results (few studies in comparisons).
A Cochrane review «Antithrombotic treatment after stroke due to intracerebral haemorrhage»1 «Perry LA, Berge E, Bowditch J et al. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database Syst Rev 2017;5():CD012144. »1 included 2 studies with a total of 121 subjects. Both studies included participants with ICH diagnosed by CT. Both studies were of short-term parenteral anticoagulation early after intracerebral haemorrhage (ICH). One study used 5000 units of heparin s.c. every 8 hours starting at day 4 after ICH. Another one used 40 mg/day of enoxaparin s.c. after the first 48 hours after ICH. The studies did not report the chosen primary outcome (a composite outcome of all serious vascular events including ischaemic stroke, myocardial infarction, other major ischaemic event, ICH, major extracerebral haemorrhage, and vascular death). Parenteral anticoagulation did not cause a statistically significant difference in case fatality (RR 1.25, 95% CI 0.38 to 4.07; one RCT, n= 46), ICH, or major extracerebral haemorrhage (no detected events; one RCT, n= 75), growth of ICH (RR 1.64, 95% CI 0.51 to 5.29; 2 RCTs, n=121), deep vein thrombosis (RR 0.99, 95% CI 0.49 to 1.96; 2 RCTs, n=121), or major ischaemic events (RR 0.54, 95% CI 0.23 to 1.28; 2 RCTs, n=121).