Petechial brain hemorrhage

There is a patient on our medicine service who was strangulated and had a CVA from it. The infarct on MRI showed massive areas of infarct and petechial hemorrhages in the basal ganglia. Is it still safe to use anticoagulation like Lovenox or aspirin?

[caregiver222]

This is my take. In  near strangulations the petechial hemorrhages result from abnormal venous preload, which is a "one-time" problem, providing your patient isn't into auto-erotic asphyxia. Although CVA's are commonly (according to protocols) treated with anti-coagulents you have to connect the dots and recognize, vitals being the determining factor), if there was a hypertensive or atheroschlerotic co-factor. In a young patient this is unlikely. I would not give Lovenox, but low-dose aspirin has few contraindications.,