Active Removal of IntraCerebral Hematoma Via Active Irrigation

This study tests a technique called active irrigation via an external ventricular drain (EVD) to help remove blood clots from the brain (intracerebral hemorrhage or ICH). When blood leaks into the brain, it causes pressure and damage. Currently, doctors drain the fluid but the clot itself remains. This study uses a small tube plus a clot-dissolving drug (tPA) to actively wash out the blood. The goal is to determine if this approach improves outcomes compared to standard drainage alone. You may be eligible if... - You are over 18 years old - You have a spontaneous brain bleed (intracerebral hemorrhage) of 30 square cm or less - You need an external ventricular drain (EVD) placed - You are receiving active medical treatment - Treatment can begin within 72 hours of the bleed starting - Your blood clotting tests are normal (if needed) You may NOT be eligible if... - Both your pupils are fixed and dilated - You have a structural cause for the bleed (like an aneurysm or arteriovenous malformation) - You have an uncorrectable bleeding disorder - You do not need an EVD - You are pregnant Talk to your doctor to see if this trial is right for you.