Journal article
Traumatic Intracranial Hemorrhage in Patients Taking Dabigatran: Report of 3 Cases and Review of the Literature
Neurosurgery, Vol.73(2), pp.E368-E374
08/2013
DOI: 10.1227/01.neu.0000430763.95349.5f
PMID: 23670031
Abstract
BACKGROUND AND IMPORTANCE:Dabigatran is a direct thrombin inhibitor gaining popularity as a stroke prevention agent in patients with atrial fibrillation. In comparison with warfarin, dabigatran showed superiority in stroke prevention, but lower rates of major hemorrhage and intracerebral hemorrhage. Although warfarin has a well-established reversal strategy, there is far less experience reversing dabigatran.\nCLINICAL PRESENTATION:We present our experience with 3 patients who experienced an intracranial hemorrhage either spontaneously or after low-energy cranial trauma and review the available literature describing dabigatran use in patients with traumatic brain injury.\nCONCLUSION:Intracranial hemorrhage in patients taking anticoagulants and/or antiplatelets can have either a benign or malignant clinical course. At this time, there is little experience with dabigatran reversal; however, several strategies for rapid reversal have been proposed. All patients with intracranial hemorrhage taking dabigatran should be admitted for close neurological monitoring and serial imaging.\nABBREVIATIONS:aPTT, activated partial prothrombin timecSDH, chronic subdural hematomaCT, computerized tomographyGCS, Glasgow Coma ScaleGFR, glomerular filtration rateINR, international normalized ratioIPH, intraparenchymal hemorrhagetSAH, traumatic subarachnoid hemorrhageTT, thrombin time
Details
- Title: Subtitle
- Traumatic Intracranial Hemorrhage in Patients Taking Dabigatran: Report of 3 Cases and Review of the Literature
- Creators
- Shafik Wassef - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IowaTaylor AbelAndrew GrossbachStephanus ViljoenAdam JacksonMatthew A Howard IIIJeremy Greenlee
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.73(2), pp.E368-E374
- DOI
- 10.1227/01.neu.0000430763.95349.5f
- PMID
- 23670031
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Language
- English
- Date published
- 08/2013
- Academic Unit
- Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984020799902771
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