Ultra-Early, Minimally inVAsive intraCerebral Haemorrhage evacUATion Versus Standard trEatment

Exclusion Criteria

• •1. Brainstem ICH
• •2. ICH secondary to trauma, where brain injury is judged more likely to be due to the broad effects of trauma rather than the focal ICH.
• •3. Hereditary or acquired hemorrhagic diathesis or coagulation factor deficiency (in liver disease, INR\>1.4).
• •4. Platelet count \<75,000
• •5. Unreversible heparinization or anticoagulation. If reversing warfarin, INR should be ≤1.4 before procedure commences. Reversal of heparin by protamine, dabigatran by idarucizumab and rivaroxaban, apixaban and enoxaparin by andexanet (where available) is permitted. Unreversed anticoagulation with a last dose within 48 hours is an exclusion.
• •6. Recent (\<12 hours) parenteral GPIIb/IIIa antagonist.
• •7. Recent (\<1 hour) thrombolysis. If the ICH has occurred between 1 and 12 hours following thrombolysis, cryoprecipitate (1U per 10kg) and tranexamic acid must be administered prior to treatment.
• •8. Participation in any investigational study in the last 30 days
• •9. Pregnant women (clinically evident)
• •10. Co-morbidities or advance care directive preventing general anaesthesia for the procedure.
• •11. Known terminal illness such that the patients would not be expected to survive a year.
• •12. Planned withdrawal of care or comfort care measures.
• •13. Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study.