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Published in:

01-02-2014

Dabigatran-associated subdural hemorrhage: using thromboelastography (TEG^®) to guide decision-making

Authors: Ron Neyens, Nicole Bohm, Madelyne Cearley, Charles Andrews, Julio Chalela

Published in: Journal of Thrombosis and Thrombolysis | Issue 2/2014

Abstract

Novel oral anticoagulants present challenges and uncertainties in the management of hemorrhagic emergencies. An 84-year-old man taking dabigatran presented with a subdural hematoma requiring neurosurgical intervention. Routine coagulation assays were prolonged at admission and following administration of Factor VIII Inhibitor Bypassing Activity (FEIBA). Thromboelastography (TEG^®) was utilized to assess clot dynamics prior to placement of a subdural drain, which was safely inserted despite a prolonged thrombin time (TT). Exclusive reliance on the TT may delay necessary interventions. TEG^® may be a valuable tool to investigate hemostasis in patients on dabigatran requiring emergent procedures.

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Title: Dabigatran-associated subdural hemorrhage: using thromboelastography (TEG®) to guide decision-making
Authors: Ron Neyens
Nicole Bohm
Madelyne Cearley
Charles Andrews
Julio Chalela
Publication date: 01-02-2014
Publisher: Springer US
Published in: Journal of Thrombosis and Thrombolysis / Issue 2/2014
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-013-0933-9

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