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Updated: Feb 8, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
[The use of Idarucizumab in intracerebral bleeding - a case report]
Björn Alexander Hummel1, Sebastian Senger2, Christian Schleicher1
1Institut für Klinische Hämostaseologie und Transfusionsmedizin Universitätsklinikum des Saarlandes Homburg.
History And Clinical Findings:
82-year old male patient suspected of having cerebral hemorrhage under anticoagulation therapy with Dabigatran due to atrial fibrillation.
Investigations:
CT scan showed bilateral chronic subdural hematomas with fresh blood in left-subdural hematoma and midline shift. Laboratory analysis shows only a moderately high Dabigatran level but thrombin time was high out of range.
Diagnosis:
Fall-related intracerebral haemorrhage and subdural hematoma under anticoagulation therapy.
Therapy And Course:
Neurosurgical hematoma evacuation and trepanation after preoperative use of Idarucizumab as an antidote for Dabigatran to stop anticoagulative effects and secure normal bleeding conditions, led to reduced midline shift. We started heparin-based anticoagulation first followed by Dabigatran again in clinical steady state and after rehabilitation with neurologically low-grade residuals.
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