Intracranial hematomas developing during dabigatran treatment remained small to moderate, did not expand, and resulted in good clinical outcomes (mRS 0-1 in 7 of 9 episodes).
Case Report (n=8)
Yes
Intracranial hemorrhages that occur during dabigatran therapy for non-valvular atrial fibrillation appear to remain small to moderate, do not readily expand, and are clinically manageable.
BACKGROUND: The incidence of intracranial bleeding during dabigatran treatment is lower than that during warfarin treatment. The characteristics of intracranial hemorrhage during dabigatran therapy, however, remain unclear. METHODS AND RESULTS: The clinical data and treatment summaries of 9 intracranial bleeds that developed during dabigatran treatment in 8 patients with non-valvular atrial fibrillation were retrospectively reviewed. Five patients had small-moderate subdural hematomas, 2 had intracerebral hemorrhage and 1 had traumatic subarachnoid and parenchymal hemorrhage associated with cerebral contusion. Activated partial thromboplastin time upon admission ranged from 31.6 to 72.4s. After admission, systolic blood pressure in the 2 patients with intracerebral hemorrhage was maintained below 140 mmHg, and the subdural hematomas in 4 patients were surgically treated. None of the hematomas became enlarged and outcome was good in most cases. CONCLUSIONS: Hematomas that arise due to acute intracranial bleeding during dabigatran treatment seem to remain small to moderate, hard to expand, and manageable.
Komori et al. (Wed,) conducted a case report in Intracranial hemorrhage during dabigatran treatment for non-valvular atrial fibrillation (n=8). Dabigatran was evaluated on Hematoma expansion and clinical outcome (modified Rankin Scale). Intracranial hematomas developing during dabigatran treatment remained small to moderate, did not expand, and resulted in good clinical outcomes (mRS 0-1 in 7 of 9 episodes).