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Prehospital Thrombolysis: A Manual from Berlin
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Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Thrombolysis in a stroke patient on dabigatran anticoagulation: case report and synopsis of published cases

Waltraud Pfeilschifter1, Mario Abruscato, Susanne Hövelmann

  • 1Goethe University Hospital, Department of Neurology, Frankfurt am Main, Hanau, Germany.

Case Reports in Neurology
|April 30, 2013
PubMed

We present the case of an aphasic 77-year-old stroke patient with left distal M1 occlusion who received rt-PA for thrombolysis while on oral anticoagulant treatment with dabigatran (150 mg b.i.d.). Coagulation parameters were normal (thrombin time 20 s, aPTT 20 s, INR 1.08) and the patient improved from an NIHSS of 15 to 5 within 24 h with sonographic evidence of M1 recanalization. She did not develop intracranial bleeding complications but showed unusually large diffuse skin ecchymoses. In our report, we give an overview of all reported cases of thrombolysis under dabigatran anticoagulation and discuss the questions of medication adherence under novel oral anticoagulants (NOA) and the safety of NOA in terms of secondary intracerebral hemorrhage after stroke.

Keywords:
AnticoagulationAtrial fibrillationFibrinolyticHemorrhageStrokeThrombolysis

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