Dabigatran-related intracerebral hemorrhage resulting in hematoma expansion

J Stroke Cerebrovasc Dis. 2014 Feb;23(2):e133-4. doi: 10.1016/j.jstrokecerebrovasdis.2013.08.011. Epub 2013 Oct 6.

Abstract

Warfarin-related intracerebral hemorrhage carries a particularly high risk of neurologic deterioration and death because of a high rate of hematoma expansion of about 50%. Novel oral anticoagulants (NOACs)--apixaban, dabigatran, and rivaroxaban--have a significantly smaller risk of intracerebral hemorrhage (ICH). However, two facts make this situation complicated: First, the risk of hematoma expansion is unknown for NOACs. Second, there is no specific antidote for neither of the NOACs. We present a case that suggests that hematoma expansion may occur after NOAC-related ICH.

Keywords: Intracerebral hemorrhage; anticoagulant; atrial fibrillation; stroke.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Benzimidazoles / administration & dosage
  • Benzimidazoles / adverse effects*
  • Cerebral Hemorrhage / chemically induced*
  • Cerebral Hemorrhage / diagnosis
  • Dabigatran
  • Fatal Outcome
  • Hematoma / chemically induced*
  • Hematoma / diagnosis
  • Humans
  • Male
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / etiology
  • Stroke / prevention & control*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • beta-Alanine / administration & dosage
  • beta-Alanine / adverse effects
  • beta-Alanine / analogs & derivatives*

Substances

  • Anticoagulants
  • Benzimidazoles
  • beta-Alanine
  • Dabigatran