Hemorrhagic transformation is often seen as a con- traindication to early (<2 weeks of stroke onset) oral anticoagulation, although no randomized trial has been done that directly addresses the question. A multicenter, prospective international study of con- secutive patients with acute ischemic stroke and AF that included a second CT 24 to 72 hours after stroke onset found that the presence of hemorrhagic trans- formation led to an average delay in anticoagulation CLINICAL STATEMENTS AND GUIDELINES Kleindorfer of 12 days and that this delay was not associated with a significant rise in the rate of recurrent stroke.76 Large infarcts, for example, the entire territory of either the middle, anterior, or posterior cerebral artery, had nearly twice the risk of hemorrhagic transforma- tion as smaller infarcts in this series.76 13. TEE, cardiac CT, and cardiac MRI will provide actionable information in a minority of patients with acute stroke. 