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Die Assoziation der zerebralen Amyloidangiopathie mit Lob\u00e4rblutungen, eine hohe Mortalit\u00e4t intrazerebraler Blutungen insbesondere unter oraler Antikoagulation sowie das hohe Rezidivrisiko solcher Blutungen erfordern eine strenge und interdisziplin\u00e4re Risiko-Nutzen-Abw\u00e4gung. Vitamin-K-Antagonisten erh\u00f6hen das Risiko f\u00fcr die mit intrazerebralen Blutungen vergesellschaftete Mortalit\u00e4t um 60\u202f% und sollten daher m\u00f6glichst vermieden bzw. speziellen klinischen Situationen (z.\u202fB. mechanischer Aortenklappenersatz) vorbehalten sein. Auch der Einsatz von neuen oralen Antikoagulanzien und Thrombozytenaggregationshemmern bedarf einer strengen Risiko-Nutzen-Abw\u00e4gung, da auch diese Substanzen das zerebrale Blutungsrisiko erh\u00f6hen. Insbesondere bei Patienten mit einer absoluten Arrhyhtmie bei Vorhofflimmern ist der interventionelle Vorhofohrverschluss eine therapeutische Alternative. 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