Abstract
With the increasing use of novel oral anticoagulants (NOACs) or direct oral anticoagulants, vascular neurologists and neurocritical care providers are more commonly encountering situations in which decisions need to be made about either starting or reversing these medications. The most common clinical indication for the NOACs is atrial fibrillation, and the most dreaded complication of NOACs is intracranial hemorrhage (ICH). This brief review will summarize the data on the safety and efficacy of the NOACs, with an emphasis on ICH, as well as the strategies to reverse the anticoagulation effects of the NOACs in those suffering bleeding complications.