Journal of Thrombosis and Thrombolysis

, Volume 37, Issue 2, pp 80–83 | Cite as

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

  • Ron Neyens
  • Nicole Bohm
  • Madelyne Cearley
  • Charles Andrews
  • Julio Chalela


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.


Dabigatran Intracranial hemorrhage Thromboelastography Prothrombin complex concentrates FEIBA 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ron Neyens
    • 1
  • Nicole Bohm
    • 2
  • Madelyne Cearley
    • 1
  • Charles Andrews
    • 3
  • Julio Chalela
    • 3
  1. 1.Department of PharmacyMedical University of South CarolinaCharlestonUSA
  2. 2.Department of Clinical Pharmacy and Outcome SciencesSouth Carolina College of PharmacyCharlestonUSA
  3. 3.Department of NeurosciencesMedical University of South CarolinaCharlestonUSA

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