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Reminder of important clinical lesson
CASE REPORT
Apixaban-induced subdural bleeding: case presentation and literature review
  1. Eman Alayad1,
  2. Sami Khairy2,
  3. Ahmed Aloraidi3
  1. 1Department of Neurosurgery, King Khalid University, Abha, Saudi Arabia
  2. 2Department of Neurosurgery, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
  3. 3Department of Neurosurgery, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
  1. Correspondence to Ms. Eman Alayad, eman.ayadh{at}gmail.com

Summary

Apixaban is a factor Xa inhibitor which is a non-vitamin K dependent oral anticoagulant known tocause the lowest rate of intracranial bleeding among the same kind of inibitors. In this paper, we report a rare case in a 60-year-old man with a history of hypertension and oligodendroglioma on apixaban for deep venous thrombosis who presented to our hospital with decreased level of consciousness and slurred speech with rapid deterioration. We highlight the risk of subdural bleeding requiring immediate neurosurgical intervention due to apixaban, with literature review.

  • drugs: cns (not psychiatric)
  • neurological injury

https://doi.org/10.1136/bcr-2018-224495

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    Footnotes

    • Contributors AA: conception and design, helped in editing the final manuscript. SK: acquisition of data and images, helped in editing the final manuscript. EA: writing the case report.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.