Early Minimally Invasive Image Guided Endoscopic Evacuation of Intracerebral Haemorrhage (EMINENT-ICH)

Inclusion Criteria: * Spontaneous supratentorial intracerebral hemorrhage (SSICH), defined as the sudden occurrence of bleeding into the lobar parenchyma and/or into the basal ganglia and/or thalamus that may extend into the ventricles confirmed by imaging * SSICH volume ≥20 mL \<100 mL * A focal neurological deficit consisting of either * clinically relevant hemiparesis (≥4 motor points on the NIHSS for facial palsy, motoric upper and lower extremities combined) * clinically relevant motor or sensory aphasia (≥2 points on the NIHSS) * clinically relevant hemi-inattention (formerly neglect, 2 points on the NIHSS) * decreased level of consciousness (Glasgow Coma Scale (GCS)≤13) * Presenting GCS 5 - 15 (in intubated patients GCS assessment will be performed after Rutledge et al. or if impossible, the last pre-intubation GCS will be used) * Endoscopic hematoma evacuation can be initiated within 24 hours after the patient was last seen well/symptom onset * Informed consent of patient or appropriate surrogate (for patients without competence) Exclusion Criteria: * SSICH due to known or suspected structural abnormality in the brain (e.g. vascular malformation, aneurysm, arteriovenous malformation (AVM), brain tumor) and/or brain trauma and/or hemorrhagic conversion of an ischemic infarction * Multiple simultaneous intracranial hemorrhages (ICH) (e.g. multifocal ICH, chronic subdural hematoma (cSDH), acute subdural hematoma (aSDH), SAH) * Infratentorial hemorrhage or midbrain extension/involvement of the hemorrhage * Coagulation disorder (including anticoagulation) with an international normalized ratio (INR) of \>1.5 which cannot be pharmacologically reverted until the planned time of evacuation * Pregnancy * Relevant disability prior to SSICH (mRS \>2) * Any comorbid disease or condition expected to compromise survival or ability to complete follow-up assessments through 180 days (e.g. bilateral fixed dilated pupils)