Management of Apixaban-Associated Subdural Hematoma

A Case Report on the Use of Factor Eight Inhibitor Bypassing Activity

Derrick R. Rinehart, Nicholas R. Lockhart, Leslie Hamilton, James Langdon, Anthony Rowe

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: We report a case of a patient receiving apixaban who developed a spontaneous subdural hematoma and declining mental status that improved after administration of a single dose of factor eight inhibitor bypassing activity. Design: Case report. Setting: Comprehensive Stroke Center, Neurocritical Care Unit. Patient: A 76-year-old man presented to an outside facility with a chief complaint of headache and pain behind his right eye. A CT scan of his head revealed a subdural hematoma. The patient was transferred to our facility with worsening clinical status. Interventions: After a confirmatory cranial CT scan revealed a worsening subdural hematoma with midline shift, a single dose of factor VIII inhibitor bypassing activity (25 U/kg) was administered. Measurements and Main Results: Coagulation tests following the administration of factor VIII inhibitor bypassing activity and a follow-up CT scan confirmed hemostasis. The patient was discharged home with no focal deficits. Conclusions: Factor VIII inhibitor bypassing activity may be a viable, nonspecific reversal agent for life-threatening bleeding associated with apixaban.

Original languageEnglish (US)
Pages (from-to)e203-e207
JournalCritical Care Medicine
Volume43
Issue number6
DOIs
StatePublished - Jun 20 2015

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Subdural Hematoma
Factor VIII
Hemostasis
Headache
Stroke
Head
Hemorrhage
Pain
Feiba
apixaban

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Management of Apixaban-Associated Subdural Hematoma : A Case Report on the Use of Factor Eight Inhibitor Bypassing Activity. / Rinehart, Derrick R.; Lockhart, Nicholas R.; Hamilton, Leslie; Langdon, James; Rowe, Anthony.

In: Critical Care Medicine, Vol. 43, No. 6, 20.06.2015, p. e203-e207.

Research output: Contribution to journalArticle

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