Restarting blood thinners after an intracranial hemorrhage is one of the most challenging decisions in neurology and stroke care. Restart too early and the risk of recurrent bleeding rises. Wait too long and patients may be left vulnerable to stroke or other thromboembolic complications. In this episode, we break down the latest evidence on when to resume antiplatelet and anticoagulant therapy, why recommendations differ for conditions such as mechanical heart valves and atrial fibrillation, and how factors like hemorrhage location and cerebral amyloid angiopathy shape decision making. We also explore how imaging findings and validated risk assessment tools can help individualize treatment for each patient. Whether you're a neurologist, emergency physician, internist, pharmacist, or trainee, you'll leave with practical, evidence-based strategies to navigate one of the most complex dilemmas in modern neurovascular care.