Idarucizumab for a traumatic head injury patient taking dabigatran
Abstract Background Dabigatran is one of the four drugs currently used as a direct oral anticoagulant in Japan. Idarucizumab, which specifically targets dabigatran, was recently approved in Japan. We present a case of intracranial hemorrhage in a traumatic brain injury patient taking dabigatran who...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12245-018-0202-y |
| _version_ | 1818330642616680448 |
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| author | Shuhei Maruyama Koichi Hayakawa Shuji Kanayama Hiromu Iwamura Daiki Wada Fukuki Saito Yasushi Nakamori Yasuyuki Kuwagata |
| author_facet | Shuhei Maruyama Koichi Hayakawa Shuji Kanayama Hiromu Iwamura Daiki Wada Fukuki Saito Yasushi Nakamori Yasuyuki Kuwagata |
| author_sort | Shuhei Maruyama |
| collection | DOAJ |
| description | Abstract Background Dabigatran is one of the four drugs currently used as a direct oral anticoagulant in Japan. Idarucizumab, which specifically targets dabigatran, was recently approved in Japan. We present a case of intracranial hemorrhage in a traumatic brain injury patient taking dabigatran who was treated by administering idarucizumab. Case presentation A 72-year-old man was injured in a traffic accident and was transferred to our emergency room. On arrival, his Glasgow Coma Scale score was 14 (eye, 3; verbal, 5; motor, 6), and his other vital signs were stable. Computed tomography (CT) imaging on arrival showed a small intracranial hematoma. A second CT 3 h later revealed expansion of the hematoma. We received information that he was taking dabigatran only after the second CT. Idarucizumab was then promptly administered, and emergency craniotomy for hematoma removal was performed. There was no tendency for bleeding during the operation, and blood transfusion was not required during the perioperative period. Although the patient underwent additional surgery for subdural effusion and hydrocephalus, his postoperative course was uneventful. He was transferred to a rehabilitation hospital on postoperative day 102. Conclusion We managed a patient taking dabigatran who suffered traumatic intracranial hemorrhage by administering idarucizumab preoperatively without the need for blood transfusion perioperatively. We suggest that idarucizumab could be a potent therapeutic bridge to definitive surgical management in such patients with traumatic brain injury who are taking dabigatran. |
| first_indexed | 2024-12-13T13:07:12Z |
| format | Article |
| id | doaj.art-5761b40f4b46489c810710fc19eaca90 |
| institution | Directory Open Access Journal |
| issn | 1865-1372 1865-1380 |
| language | English |
| last_indexed | 2024-12-13T13:07:12Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-5761b40f4b46489c810710fc19eaca902022-12-21T23:44:47ZengBMCInternational Journal of Emergency Medicine1865-13721865-13802018-10-011111410.1186/s12245-018-0202-yIdarucizumab for a traumatic head injury patient taking dabigatranShuhei Maruyama0Koichi Hayakawa1Shuji Kanayama2Hiromu Iwamura3Daiki Wada4Fukuki Saito5Yasushi Nakamori6Yasuyuki Kuwagata7Department of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Emergency and Critical Care Medicine, Kansai Medical University HospitalAbstract Background Dabigatran is one of the four drugs currently used as a direct oral anticoagulant in Japan. Idarucizumab, which specifically targets dabigatran, was recently approved in Japan. We present a case of intracranial hemorrhage in a traumatic brain injury patient taking dabigatran who was treated by administering idarucizumab. Case presentation A 72-year-old man was injured in a traffic accident and was transferred to our emergency room. On arrival, his Glasgow Coma Scale score was 14 (eye, 3; verbal, 5; motor, 6), and his other vital signs were stable. Computed tomography (CT) imaging on arrival showed a small intracranial hematoma. A second CT 3 h later revealed expansion of the hematoma. We received information that he was taking dabigatran only after the second CT. Idarucizumab was then promptly administered, and emergency craniotomy for hematoma removal was performed. There was no tendency for bleeding during the operation, and blood transfusion was not required during the perioperative period. Although the patient underwent additional surgery for subdural effusion and hydrocephalus, his postoperative course was uneventful. He was transferred to a rehabilitation hospital on postoperative day 102. Conclusion We managed a patient taking dabigatran who suffered traumatic intracranial hemorrhage by administering idarucizumab preoperatively without the need for blood transfusion perioperatively. We suggest that idarucizumab could be a potent therapeutic bridge to definitive surgical management in such patients with traumatic brain injury who are taking dabigatran.http://link.springer.com/article/10.1186/s12245-018-0202-yDabigatranDirect oral anticoagulantsIdarucizumabSpecific neutralizing drugTraumatic brain injuryTraumatic intracranial hemorrhage |
| spellingShingle | Shuhei Maruyama Koichi Hayakawa Shuji Kanayama Hiromu Iwamura Daiki Wada Fukuki Saito Yasushi Nakamori Yasuyuki Kuwagata Idarucizumab for a traumatic head injury patient taking dabigatran International Journal of Emergency Medicine Dabigatran Direct oral anticoagulants Idarucizumab Specific neutralizing drug Traumatic brain injury Traumatic intracranial hemorrhage |
| title | Idarucizumab for a traumatic head injury patient taking dabigatran |
| title_full | Idarucizumab for a traumatic head injury patient taking dabigatran |
| title_fullStr | Idarucizumab for a traumatic head injury patient taking dabigatran |
| title_full_unstemmed | Idarucizumab for a traumatic head injury patient taking dabigatran |
| title_short | Idarucizumab for a traumatic head injury patient taking dabigatran |
| title_sort | idarucizumab for a traumatic head injury patient taking dabigatran |
| topic | Dabigatran Direct oral anticoagulants Idarucizumab Specific neutralizing drug Traumatic brain injury Traumatic intracranial hemorrhage |
| url | http://link.springer.com/article/10.1186/s12245-018-0202-y |
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