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J Stroke Cerebrovasc Dis. 2014 Feb;23(2):e133-4. doi: 10.1016/j.jstrokecerebrovasdis.2013.08.011. Epub 2013 Oct 6.

Dabigatran-related intracerebral hemorrhage resulting in hematoma expansion.

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  • 1Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. Electronic address:
  • 2Department of Neurology, Frankfurt am Main, Germany; Department of Neurology, Heidelberg University Hospital, Germany.
  • 3Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark.
  • 4Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.


Warfarin-related intracerebral hemorrhage carries a particularly high risk of neurologic deterioration and death because of a high rate of hematoma expansion of about 50%. Novel oral anticoagulants (NOACs)--apixaban, dabigatran, and rivaroxaban--have a significantly smaller risk of intracerebral hemorrhage (ICH). However, two facts make this situation complicated: First, the risk of hematoma expansion is unknown for NOACs. Second, there is no specific antidote for neither of the NOACs. We present a case that suggests that hematoma expansion may occur after NOAC-related ICH.

Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.


Intracerebral hemorrhage; anticoagulant; atrial fibrillation; stroke

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