Direct oral anticoagulants (DOAC), including dabigatran, rivaroxaban, apixaban, and edoxaban, are commonly used to prevent thromboembolism in various populations. Nevertheless, ischemic stroke (IS) and intracranial hemorrhage (ICH) still occur during DOAC therapy and are difficult to manage [1]. Several studies have reported on the effects of preceding anticoagulant (AC) therapy on stroke severity. In the case of acute IS, data from the Get With the Guidelines–Stroke (GWTG-Stroke) Registry in the United States revealed that therapeutic warfarin and DOACs reduced the odds of moderate or severe stroke and in-hospital mortality in patients receiving this treatment compared to AC non-users [2].