Key result
Idarucizumab reverses dabigatran-induced coagulopathy and stabilizes acute subdural hematoma in a mobile stroke unit.
Why the study?
There are no prior descriptions of idarucizumab administration in the prehospital setting for dabigatran-related intracranial hemorrhage.
Can idarucizumab be safely and effectively administered in a mobile stroke unit for dabigatran-associated intracranial hemorrhage?
Case Report (n=1)
No
Can idarucizumab be safely and effectively administered in a mobile stroke unit for dabigatran-associated intracranial hemorrhage?
Idarucizumab can be safely and effectively administered in the prehospital setting (mobile stroke unit) for dabigatran-associated intracranial hemorrhage.
Supports prehospital idarucizumab feasibility in dabigatran ICH; leaves open need for prospective trials before adoption.
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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Thirunavukkarasu et al. (2020) conducted a case report in Dabigatran-associated subdural hemorrhage (n=1). Idarucizumab was evaluated on Reversal of coagulopathy and hematoma stability. Idarucizumab successfully reversed dabigatran-induced coagulopathy and stabilized an acute subdural hematoma in a patient treated in a prehospital mobile stroke unit.
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