Eight patients received andexanet alfa for FXa inhibitor associated intracranial hemorrhage (6 male, median age 70, median GCS 14). Four patients presented with subdural hemorrhage, three with intracerebral hemorrhage, and one with subarachnoid hemorrhage. Two patients received prothrombin complex concentrate prior to andexanet alfa. Six patients had “good” or “excellent” hemostasis as defined by ANNEXA-4 criteria. Six thrombotic events in four patients were recorded including, multifocal ischemic stroke, cortical vein thrombosis, pulmonary embolism, superficial venous thrombosis and two myocardial infarctions occurring a median of 3 days post bleed. Four patients were dead at 30 days, two patients were discharged to inpatient rehab, one to nursing facility and one to a long term acute care facility.