A 74-year-old man presented with spontaneous, acute onset of confusion and headache. He had no preceding head trauma or falls. He had a history of atrial fibrillation with an annual stroke risk of 2.9% (based on points accrued for hypertension and age ≥65 years using the CHA2DS2-VASc score1). He was being treated with rivaroxaban, 20 mg daily. He took his last dose 14 hours prior to presentation. Other medications included ramipril and rosuvastatin.
Sholzberg M, Xu Y. Coagulation Test Interpretation in a Patient Taking Direct Oral Anticoagulant Therapy. JAMA. 2018;320(14):1485–1486. doi:10.1001/jama.2018.13998
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