Reversal of dabigatran with idarucizumab in hyperacute stroke: a new paradigm?

Amy Ting, Abhay R Venkat, Yash Gawarikar and Ronak Patel
Med J Aust 2019; 210 (7): . || doi: 10.5694/mja2.50122
Published online: 15 April 2019

A 68‐year‐old man presented with hyperacute stroke one hour after symptom onset. The clinical picture was that of a right middle cerebral artery syndrome with left sided deficit and a National Institute of Health Stroke Score (NIHHS) of 7 on admission. The NIHHS is based on rapid neurological assessment for hyperacute stroke, ranging from 0 to 42, with higher scores indicating greater stroke severity. Blood pressure on admission was 106/85 mmHg. The patient was taking dabigatran exelate 150 mg twice a day for atrial fibrillation, and had taken the last dose 5 hours before presentation. His pre‐morbid modified Rankin score (mRS) was 0 and admission score was 2 — the mRS reflects functional independence and is rated from 0 to 6, with scores greater than 3 implying assistance with mobility.

  • 1 Canberra Hospital, Canberra, ACT
  • 2 Calvary Public Hospital Bruce, Canberra, ACT
  • 3 Australian National University, Canberra, ACT


Competing interests:

No relevant disclosures.

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