Just the facts Management of life-threatening bleeding with oral anticoagulant use in the emergency department

摘要

A 63-year-old female is brought to the emergency department (ED) by ambulance after her partner noted progressiveheadache, vomiting, and gait instability starting six hours ago. Her past medical history includes atrial fibrillation andhypertension. Her medications include a “blood thinner,” the name of which neither she nor her partner can recall.She is afebrile, with a blood pressure of 165/95 and otherwise unremarkable vital signs. On examination, she is alert,oriented, and cooperative. Dysarthria is accompanied by a right-sided facial droop, and right-sided upper and lowerextremity weakness is noted. A computed tomography (CT) scan of the brain reveals a 2 × 2 × 3 cm intracerebral hemorrhage in the left basal ganglia.