Minimally Invasive Surgery for Spontaneous Deep Intracerebral Hemorrhage

Inclusion Criteria: * Age 18 to 80 years * Spontaneous basal ganglia intracerebral hemorrhage confirmed by non-contrast CT * Hematoma volume between 30 and 80 mL (calculated using the ABC/2 method) * Time from symptom onset to enrollment ≤ 72 hours (for patients with an unknown onset time, the last known well time will be used) * Glasgow Coma Scale (GCS) score between 5 and 14 * Pre-stroke modified Rankin Scale (mRS) score of 0 to 1 Exclusion Criteria: * Secondary intracerebral hemorrhage due to trauma, brain tumor, arteriovenous malformation, cerebral aneurysm, or hemorrhagic transformation of ischemic stroke * Infratentorial hemorrhage involving the brainstem or cerebellum * Primary thalamic hemorrhage * Intraventricular extension occupying more than 50% of either lateral ventricle * NIHSS score \< 5 * Bilaterally fixed and dilated pupils with no light reflexes * Decerebrate posturing * Platelet count \< 75,000/μL * IINR \> 1.4 after correction * Ongoing anticoagulation that cannot be rapidly reversed * Indication for long-term anticoagulation within 5 days of symptom onset * End-stage renal disease * End-stage liver disease * Presence of a mechanical heart valve * Comorbid condition associated with a life expectancy \< 6 months * Inability or unwillingness of the participant or legally authorized representative to provide written informed consent