title: Traumatic intracranial hemorrhage in patients taking dabigatran: report of 3 cases and review of the literature.
abstract: BACKGROUND
  Dabigatran is a direct thrombin inhibitor gaining popularity as a stroke prevention agent in patients with atrial fibrillation. In comparison with warfarin, dabigatran showed superiority in stroke prevention, but lower rates of major hemorrhage and intracerebral hemorrhage. Although warfarin has a well-established reversal strategy, there is far less experience reversing dabigatran.
  
  
  METHODS
  We present our experience with 3 patients who experienced an intracranial hemorrhage either spontaneously or after low-energy cranial trauma and review the available literature describing dabigatran use in patients with traumatic brain injury.
  
  
  CONCLUSIONS
  Intracranial hemorrhage in patients taking anticoagulants and/or antiplatelets can have either a benign or malignant clinical course. At this time, there is little experience with dabigatran reversal; however, several strategies for rapid reversal have been proposed. All patients with intracranial hemorrhage taking dabigatran should be admitted for close neurological monitoring and serial imaging.
authors.affiliation: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Shafik N
authors.initials: SN
authors.lastname: Wassef
authors.forename: Taylor J
authors.initials: TJ
authors.lastname: Abel
authors.forename: Andrew
authors.initials: A
authors.lastname: Grossbach
authors.forename: Stephanus V
authors.initials: SV
authors.lastname: Viljoen
authors.forename: Adam W
authors.initials: AW
authors.lastname: Jackson
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Howard
authors.forename: Jeremy D W
authors.initials: JD
authors.lastname: Greenlee
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000991:Antithrombins / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D001562:Benzimidazoles / Q000009:adverse effects*; D006259:Craniocerebral Trauma / Q000150:complications*; D000069604:Dabigatran; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008297:Male; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran