Consensus conference for Minimally invasive surgery for ICH - PROJECT SUMMARY/ABSTRACT The role of minimally invasive surgery (MIS) for treatment of ICH is well studied across many individual trials but lacks a joint community approach to harmonize strategies for a definitive trial to potentially bring MIS into practice changing guidelines. The Minimally Invasive Surgery Consensus ICH Conference will bring together a diverse and comprehensive group of field- leading experts as well as the stroke community at large to define the specific discoveries needed to produce level one evidence regarding the possible value of MIS. Specific grant aims are: To assess the evidence requirements to promote practice change in Minimally Invasive Surgery for ICH (MIS-ICH). We will engage the full range of the US scientific community with regards to specific discoveries needed to produce level one evidence regarding the possible value of MIS. To convene a fully representative group of medical professionals caring for ICH patients to develop a categorical classification of data deficiencies requiring mitigation in a test(s) of the value of MIS-ICH. We will engage the full range of the ICH scientific work force across specialties, geography, age, race and ethnicity to develop a prioritized list of discovery targets. To address the range of emergency medical, acute care, urgent surgical, post-surgical care, recovery and rehabilitation requirements for ICH patients who would be subject to MIS-ICH therapy. The participants will address the needs for a national level approach to a large practice changing trial and or a sustained Platform Trial approach to develop clear evidence around the current promising MIS-ICH trial results suggesting functional benefit for an acute surgical intervention. This evidence will be shared publicly via peer reviewed commentary and in discussion forums across interested consortia who support clinical trials in the US. The full day conference will define the unanswered questions in ICH care, the standards in surgical deliverables needed from different surgical techniques, the standards for pre and post- operative care, and answer biological questions across the general population. Expanding both the workforce and the trial outreach is key to bringing health care improvements, drugs and devices to populations with rare intracranial hemorrhagic diseases.