title: Thrombolysis in a stroke patient on dabigatran anticoagulation: case report and synopsis of published cases.
abstract: We present the case of an aphasic 77-year-old stroke patient with left distal M1 occlusion who received rt-PA for thrombolysis while on oral anticoagulant treatment with dabigatran (150 mg b.i.d.). Coagulation parameters were normal (thrombin time 20 s, aPTT 20 s, INR 1.08) and the patient improved from an NIHSS of 15 to 5 within 24 h with sonographic evidence of M1 recanalization. She did not develop intracranial bleeding complications but showed unusually large diffuse skin ecchymoses. In our report, we give an overview of all reported cases of thrombolysis under dabigatran anticoagulation and discuss the questions of medication adherence under novel oral anticoagulants (NOA) and the safety of NOA in terms of secondary intracerebral hemorrhage after stroke.
authors.affiliation: Goethe University Hospital, Department of Neurology, Frankfurt am Main, Hanau, Germany.
authors.forename: Waltraud
authors.initials: W
authors.lastname: Pfeilschifter
authors.forename: Mario
authors.initials: M
authors.lastname: Abruscato
authors.forename: Susanne
authors.initials: S
authors.lastname: Hövelmann
authors.forename: Horst
authors.initials: H
authors.lastname: Baas
keywords: Anticoagulation; Atrial fibrillation; Fibrinolytic; Hemorrhage; Stroke; Thrombolysis