Objective: Oral anticoagulants are widely administered to patients withatrial fibrillation in order to prevent the onset of cardiogenic embolisms. However,intracranial bleeding during anticoagulant therapy often leads to fatal outcomes.Accordingly, the use of novel oral anticoagulants (NOACs), which less frequently haveintracranial bleeding as a complication, is expanding. A nationwide survey of intracranialbleeding and its prognosis in Japan reported that intracranial bleeding of advancedseverity was not common after NOAC administration. In this report, two cases from ourinstitute are presented.

Patients: Case 1 was an 85-year-old man with a right frontal lobe hemorrhagewhile under dabigatran therapy. Case 2 was an 81-year-old man who had cerebellarhemorrhage while under rivaroxaban therapy.

Result: In both patients, the clinical course progressed without aggravationof bleeding or neurological abnormalities once anticoagulant therapy was discontinued.

Conclusion: These observations suggest that intracranial hemorrhage duringNOAC therapy is easily controlled by discontinuation of the drug. NOAC administration maytherefore be appropriate despite the risk of such severe complications. Further casestudies that include a subgroup analysis with respect to each NOAC or patient backgroundwill be required to establish appropriate guidelines for the prevention of cardiogenicembolisms in patients with atrial fibrillation.