Inclusion Criteria:  Acute traumatic intracranial hemorrhage on anticoagulation for Atrial Fibrillation (AF) or Venous Thromboembolism (VTE) Patient is higher risk for stroke or other thrombotic events as witnessed by having a CHA2DS2-VASc score of > 3 (at least 3 of the following risk factors: age greater than 65, (age > 75 counts for 2 points), history of stroke or TIA (2 points), history of heart failure, history of diabetes, history of atherosclerotic vascular disease, female biological sex, history of hypertension) DOAC prescribed at label dose with creatinine clearance adjustments. DOAC at continuation dose, i.e., not initial therapy high doses in the setting of VTE  Exclusion Criteria:  Mechanical Valve or Ventricular Assist Device (VAD) SDH >8 mm maximum width or any midline shift at any time point or more than one SDH Physician plan to start/restart antiplatelet therapy during trial period Abbreviated Injury Scale other than head >3 Pregnancy Inability to understand need for adherence to study protocol Renal function below DOAC label exclusions Any active pathological bleeding (e.g. no acute blood on most recent CT) Hypersensitivity to drug or other label contraindication Any bleeding that the investigator deems unsafe to restart DOAC at 1 week post injury, or conversely unsafe to hold DOAC to 4 weeks Completion of DOAC therapy expected prior to 60 day primary endpoint, e.g. 3-6 month VTE treatment Concomitant need for strong inducers/inhibitors of p-gp and CYP3A4 Low body weight (<45kg) Inability to swallow