What is the optimal timing for initiation of anticoagulation in patients with AF presenting with an acute stroke?
For patients with acute stroke, anticoagulation should be initiated immediately upon diagnosis, preferably within 24 hours after symptom onset. For patients with ICH, anticoagulation should be delayed until the patient is medically stable, typically 7-10 days after symptom onset. In both cases, it is important to discuss the risks and benefits of anticoagulation with the patient and their family.