Minimally Invasive Surgery For Patients With Spontaneous Deep Intracerebral Hemorrhage

Inclusion Criteria: * Age 18 to 80 years * Spontaneous basal ganglia intracerebral hemorrhage confirmed by non-contrast CT scan * Hematoma volume 30-80 mL (ABC/2 method) * Time from onset/last known well ≤ 72 hours * Glasgow Coma Scale (GCS) score 5-14 at admission * Pre-stroke modified Rankin Scale (mRS) score 0-1 Exclusion Criteria: * Secondary intracerebral hemorrhage due to trauma, tumor, vascular malformation, aneurysm, or hemorrhagic transformation of ischemic stroke * Infratentorial hemorrhage (brainstem or cerebellum) * Primary thalamic hemorrhage * Extensive intraventricular hemorrhage (\>50% of one lateral ventricle) * NIHSS \< 5 at admission * Bilateral fixed dilated pupils without light reflex * Decerebrate posture * Platelet count \< 75,000/µL * INR \> 1.4 after correction * Ongoing anticoagulation that cannot be rapidly reversed * Indication for long-term anticoagulation within 5 days of onset * End-stage renal disease * End-stage liver disease * Presence of mechanical heart valve * Any comorbidity with life expectancy \< 6 months * Patient or legal representative unwilling or unable to provide written informed consent