Oral anticoagulants (OACs) are the therapy of choice for secondary prevention of ischemic stroke (IS) in patients with atrial fibrillation (AF). Posterior circulation strokes (PCS) make up roughly 20% of all IS but they have been underrepresented or excluded in many clinical trials.
The aims of this observational, prospective, multicenter study will be to evaluate the risk of recurrent ischemic embolic events or symptomatic secondary hemorrhagic transformation (HT) in patients with AF and stroke of the posterior circulation within 90 days from onset and the risk factors associated to recurrence or HT.
Consecutive patients with acute stroke of the posterior circulation, affected by AF and without contraindications to anticoagulation, will be included. Physicians will decide autonomously the timing and type of OAC. Patients will be followed for 90±2 days. Functional recovery at 90 days, mortality, the composite of stroke, TIA, symptomatic systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding will be assessed.
We expect to confirm a low risk of HT in our patients, and a safe time between 4 and 14 days after stroke for OAC introduction.

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