Traumatic fatal cerebral hemorrhage in an old patient with a history of multiple sclerosis under dabigatran： a case report and review of the literature  

作　　者：Claudia Stollberger Andreas Ulram Adam Bastovansky Josef Finsterer 

机构地区：[1]Hospital Rudolfstiftung, Juehgasse 25, A-1030 Vienna, Austria

出　　处：《Journal of Geriatric Cardiology》2015年第1期83-87,共5页老年心脏病学杂志（英文版）

摘　　要：One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoelast/c trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness. Most probably, decreased dabigatran clearance due to increased age might have contributed to the fatal course. We suggest withholding anticoagulant therapy in patients with unexplained falls. If anticoagulant therapy is deemed necessary, vitamin-K-antagonists with their potential for laboratory monitoring and reversal of anticoagulant activity should be preferred.

关 键 词：Cerebral hemorrhage ANTICOAGULATION DABIGATRAN Atrial fibrillation 

分 类 号：S856.9[农业科学—临床兽医学] Q813[农业科学—兽医学]