Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report

Abstract

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.