Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report.

Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage.

Patient Concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU).

Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma.

Interventions: The patient was treated with Idarucizumab in the MSU.

Outcomes: The subdural hematoma was treated with a burr hole evacuation and the patient was discharged to a rehabilitation facility without residual focal neurological deficits.

Lessons: Idarucizumab can be used safely and effectively to treat dabigatran-associated intracranial hemorrhage in the prehospital setting.