NDLI: Neurosurgical complications of direct thrombin inhibitors--catastrophic hemorrhage after mild traumatic brain injury in a patient receiving dabigatran.

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Neurosurgical complications of direct thrombin inhibitors--catastrophic hemorrhage after mild traumatic brain injury in a patient receiving dabigatran.

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Neurosurgical complications of direct thrombin inhibitors--catastrophic hemorrhage after mild traumatic brain injury in a patient receiving dabigatran.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Garber, Sarah T. Sivakumar, Walavan Schmidt, Richard H.
Description	Country affiliation: United States Author Affiliation: Garber ST ( Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA.)
Abstract	Dabigatran etexilate is an oral anticoagulant that acts as a direct, competitive thrombin inhibitor. Large randomized clinical trials have shown higher doses of dabigatran (150 mg taken twice daily) to be superior to warfarin in terms of stroke and systemic embolism rates in patients with nonvalvular atrial fibrillation. As a result, in 2010 the US FDA approved the use of dabigatran for the prevention of stroke and systemic embolism in patients with atrial fibrillation. Dabigatran is especially attractive in the outpatient setting because patients do not require routine monitoring with prothrombin times or international normalized ratios. To date, no effective reversal agent for dabigatran in the event of catastrophic hemorrhage has been identified. The authors report a case of an elderly patient, being treated with dabigatran for atrial fibrillation, who presented with a rapidly expanding intracranial hemorrhage after a ground-level fall. This case highlights an impending neurosurgical quandary of complications secondary to this new anticoagulation agent and suggests potential options for management.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	5
Volume Number	116
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2012-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Benzimidazoles Adverse Effects Brain Hemorrhage, Traumatic Chemically Induced Etiology Brain Injuries Complications Thrombin Antagonists & Inhibitors Beta-alanine Analogs & Derivatives Atrial Fibrillation Drug Therapy Therapeutic Use Dabigatran Factor Vii Fatal Outcome Glasgow Coma Scale International Normalized Ratio Partial Thromboplastin Time Subarachnoid Hemorrhage Tomography, X-ray Computed
Content Type	Text
Resource Type	Case study Article
Subject	Neurology (clinical) Surgery

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