How to administer anticoagulation in patients with a history of cerebral hemorrhage is one of the most difficult questions facing clinicians, and there are several key variables to consider in this setting, including the type of cerebral hemorrhage, the patient’s age, risk factors for recurrent bleeding, and indications for anticoagulation. The risk of recurrent hemorrhage must be weighed against the risk of ischemic cerebrovascular events. ( 1 ) For patients with cerebral hemorrhage, SAH, or subdural hematoma: all anticoagulants and antiplatelet agents must be discontinued during the acute period of at least 1 to 2 weeks after the hemorrhage, and appropriate medications (i.e., vitamin K, fresh frozen plasma) should be applied immediately to rapidly reverse the anticoagulant effect. ( 2 ) For patients requiring anticoagulation shortly after cerebral hemorrhage: intravenous heparin may be safer than oral anticoagulation. oral anticoagulant therapy may be restarted after 3 to 4 weeks with close monitoring and maintenance of an INR at the lower limit of the therapeutic range. ( 3 ) Special circumstances: In SAH, anticoagulation should be restarted only if the ruptured aneurysm has been eradicated; in patients with lobar hemorrhage or MRI findings of microhemorrhage and suspected amyloid cerebrovascular disease, the risk of recurrent cerebral hemorrhage may be high if anticoagulation needs to be restarted; in patients with hemorrhagic infarction, depending on the specific clinical status and potential indications for anticoagulation, anticoagulation may be continued. anticoagulation therapy.