TY  - JOUR
PY  - 2016//
TI  - Fatal consequences of climbing a ladder under apixaban and drunken
JO  - Neurologia i Neurochirurgia Polska
A1  - Stöllberger, Claudia
A1  - Finsterer, Josef
SP  - 200
EP  - 202
VL  - 50
IS  - 3
N2  - BACKGROUND: Apixaban, a factor-Xa-inhibitor, is one of the non-vitamin-K-antagonist oral anticoagulants (NOACs) which are increasingly used in atrial fibrillation (AF). In real life even patients with contraindications to vitamin K antagonists (VKAs) receive NOAC because NOAC are considered as "safer" than VKAs. CASE DESCRIPTION: In a 61-years-old man with hypertension, heart failure and paroxysmal AF apixaban was started. Despite advices from his physicians, he continued alcohol abuse and suffered from recurrent falls. After 9 months he fell from a ladder and suffered from extensive subarachnoidal and intraparenchymal hemorrhages, subdural hematoma, brain edema with midline shift and a left-sided skull fracture. Because of the inability to reverse the anticoagulant therapy, no neurosurgical intervention was carried out and the patient died without regaining consciousness. <br><br>CONCLUSIONS: Patients with recurrent falls or chronic alcohol abuse should not be considered as candidates for NOACs. If anticoagulation is deemed necessary, VKA with its potential for prompt reversibility should be favored.<br><br>Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0028-3843
UR  - http://dx.doi.org/10.1016/j.pjnns.2016.01.012
ID  - ref1
ER  -