A Multicenter, RAndomIzed, coNtrolled, umBrella Trial fOr Minimally Invasive Neurosurgery With AI-assisted Robotic guidanCe for Hemorrhagic Stroke

Inclusion Criteria

• •1. Age ≥18 years at randomization；
• •2. Diagnosed with brainstem hemorrhage via imaging (CT, CTA, etc.)；
• •3. Hematoma volume ≥3 mL；
• •4. Glasgow Coma Scale (GCS) score of 3-12；
• •5. Available for surgery within 48 hours after onset；
• •6. Modified Rankin Scale (mRS) score ≤ 1 prior to this hemorrhage；
• •7. Informed consent obtained in accordance with national laws, regulations, and applicable ethics committee requirements.
• •Patients will be excluded if they meet any of the following criteria:
• •1. Hematoma involving other regions such as the supratentorial compartment, basal ganglia, thalamus, midbrain, or ventricles.
• •2. Radiologically confirmed cerebral vascular abnormalities including ruptured aneurysms, arteriovenous malformations (AVMs), or Moyamoya disease; hemorrhagic transformation of ischemic infarcts; or recent (within 1 year) recurrence of intracerebral hemorrhage；
• •3. Any irreversible coagulation disorder or known coagulopathy; platelet count \<100,000/µL; INR \>1.4; or use of anticoagulant medication within 7 days before the current hemorrhage；
• •4. Current or probable pregnancy；
• •5. Patients with concurrent severe illness likely to influence outcome assessment；
• •6. Difficulty in follow-up or poor compliance due to any cause.