Cerebellar hematoma complicating 600 mg loading dose of Clopidogrel in combination with Tirofiban

A patient admitted for coronary angioplasty received a loading dose of Clopidogrel 600 mg, in combination with an infusion of Tirofiban and one prophylactic dose of Enoxaparin. He developed massive cerebellar hemorrhage and underwent urgent surgery. Recovery was fortunately complete and reintroduction of antiplatelet agents was guided by platelet aggregation inhibition test.