Inclusion Criteria:  CT diagnosed acute spontaneous primary supratentorial ICH. Age >18 years Baseline ICH volume 20-80 ml, estimated using the standard "A*B*C/2"calculation on the baseline CT. NIHSS≥6 and Glasgow Coma Scale score 8-12, on initial screening. Premorbid Modified Rankin score (MRS) ≤1 Systolic blood pressure140-180 millimeters of mercury (mmHg) with 160mmHg target according to practice guidelines Randomize and first evacuation attempt ≤8 hours onset using the "last seen normal" principle. Consent obtained from patient or their Substitute Decision Maker prior to enrolment.  Exclusion Criteria:  Infratentorial ICH (Brainstem or cerebellum). ICH secondary to known or suspected trauma, aneurysm, vascular malformation, hemorrhagic conversion of ischemic stroke, venous sinus thrombosis, thrombolytic treatment, tumour, or infection; or an in-hospital ICH or ICH because of any in-hospital procedure or illness. Baseline brain imaging shows evidence of acute or subacute ischemic stroke (chronic infarcts are not an exclusion). Platelets <100000, International Normalized ratio (INR)>1.3 or clotting disorder. Coumadin reversal permitted if not required during hospitalization Serious comorbidities including hepatic, renal, gastroenterologic, respiratory, cardiovascular, endocrinologic, immunologic, and hematologic disease or mechanical valve Impaired brainstem function (bilateral fixed dilated pupils, extensor posturing). Patient considered unstable in opinion of investigator. Positive pregnancy test