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Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Sibi Thirunavukkarasu1, Hayrapet Kalashyan, Glen Jickling
1Division of Neurology, University of Alberta Hospital, Alberta, Canada.
Rationale:
Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage.
Patient Concerns:
An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU).
Diagnosis:
Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma.
Interventions:
The patient was treated with Idarucizumab in the MSU.
Outcomes:
The subdural hematoma was treated with a burr hole evacuation and the patient was discharged to a rehabilitation facility without residual focal neurological deficits.
Lessons:
Idarucizumab can be used safely and effectively to treat dabigatran-associated intracranial hemorrhage in the prehospital setting.
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