口服抗凝血藥物 (oral anticoagulants, OACs) 被證實有效用於心房顫動或人工心臟瓣膜置換的中風或栓塞預防，然而，服用OACs 同時也可能造成腦內出血 (intracerebral hemorrhage, ICH) 風險提高，甚至於ICH 的急性期過後，仍可能因為存在不同風險因子，再次發生ICH 或栓塞事件，但在缺乏較高證據品質文獻下，目前對於是否恢復使用、何時再用上OACs 仍未有一致的結論，也是臨床醫療者面對的一大挑戰。不過從現有文獻當中，可以看到恢復使用OACs，似乎對於大部分病人是有效益的，適當的使用時機則應該權衡個人風險與利益做考量。因此，本文將依據目前文獻探討，常見的栓塞與出血風險因子及OACs 於ICH 後恢復使用的適當性和時機。

Oral anticoagulants (OACs) have been proven effectively to prevent stroke or systemic embolism in patients with atrial fibrillation or mechanical prosthetic heart valves. However, OAC staking are associated with increased risk of intracerebral hemorrhage in this population. Even after patients survived from intracerebral hemorrhage, different underlying risk factors can still contribute to recurrent intracerebral hemorrhage and thromboembolism. Due to lack of high quality evidence, decision making on appropriate timing to restart OACs after event is a challenge in medical practice. After available literature reviewed, it seemed that restarting OACs could benefit most patients after suffering the acute period of intracerebral hemorrhage. On the other hand, there was also much controversy on appropriate timing to restart OACs, and it should depend on individual benefit-risk ratio balance. Hence, in this article, according to the literature review, we will further discuss on risk stratification of common embolism and bleeding and appropriate timing to restarting OACs for patient with intracerebral hemorrhage.