Clinical Research Directory

Inclusion Criteria: * • Adults \> 18 years * CT evidence of acute, spontaneous lobar ICH defined as located \<1cm from the cortical surface * ICH volume is \>30cc but \<80cc as measured by (length x width x height)/2 * GCS 5-14 at presentation * NIHSS \>5 * Surgery deemed to be feasible within 16h of symptom onset Exclusion Criteria: * • Underlying secondary etiology (AVM, tumor, etc. if known or identifiable acutely) * Intraventricular extension estimated to involve \>50% of the lateral ventricle * Preoperative disability that will affect outcome as measured by modified Rankin Scale score (mRS\>1 at baseline) * Individuals presenting with GCS \<5 at presentation * Primary basal ganglia hemorrhage with lobar extension * End-stage organ failure or life expectancy \<6 months * For patients in whom the treating clinical team elects to proceed with surgical evacuation as part of clinical care, a standardized evacuation of the hematoma will be performed using neuronavigation for optimal craniotomy planning, microsurgical technique and SmartForceps System for quantifiable intraoperative data.