STOP-MSU: Stopping Haemorrhage With Tranexamic Acid for Hyperacute Onset Presentation Including Mobile Stroke Units

Inclusion Criteria: 1. Patients presenting with an acute ICH 2. Age ≥18 years 3. Treatment can commence within 2 hours of symptom onset (or in patients with unknown time of symptom onset, the time patient was last known to be well) 4. Consent can be obtained from participant or person responsible. When emergency treatment procedures have been followed the participant or person responsible will be asked for consent to continue in the study. Exclusion Criteria: 1. Glasgow coma scale (GCS) total score of \<8 2. Brainstem ICH 3. ICH volume \>70 ml as measured by the ABC/2 method 4. ICH known or suspected by study investigator to be secondary to trauma, aneurysm, vascular malformation, haemorrhagic transformation of ischaemic stroke, cerebral venous thrombosis, thrombolytic therapy, tumour, or infection 5. Any history or current evidence suggestive of venous or arterial thrombotic events within the previous 12 months, including clinical, ECG, laboratory, or imaging findings. Clinically silent chance findings of old ischemia are not considered exclusion. 6. Hereditary or acquired haemorrhagic diathesis or coagulation factor deficiency. 7. Use of heparin, low-molecular weight heparin, GPIIb/IIIa antagonist, or oral anticoagulation (e.g. warfarin, factor Xa inhibitor, thrombin inhibitor) within the previous 72 hours. 8. Pregnancy (women of childbearing potential must be tested) 9. Planned surgery for ICH within 24 hours 10. Concurrent or planned treatment with haemostatic agents (e.g. prothrombin complex concentrate, vitamin K, fresh frozen plasma, or platelet transfusion) 11. Participation in any investigational study in the last 30 days 12. Known terminal illness or planned withdrawal of care or comfort care measures 13. Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study.