Tenecteplase (TNK) in the Treatment of Intracerebral Hemorrhage (ICH)

Inclusion Criteria * Patient/legally authorized representative has signed the Informed Consent Form. * Ability to comply with the study protocol, in the investigator's judgment. * Patients 18 to 80 years of age with an ICH had occurred within 24 hours before admission. * Spontaneous supratentorial (basal ganglia, thalamus, lobar) ICH ≥30 mL measured utilizing the ABC/2 method. * Subjects with a GCS score of 5-14. * NIHSS ≥6. * Stability CT scan done at least 6 hours after baseline CT showing clot stability (growth \<5 mL as measured by ABC/2 method). If the hematoma volume measured on the stability CT scan increases by 5 mL or more, a second stability CT scan will be performed 12 hours later. * Sustained systolic blood pressure (SBP) \<180 mm Hg for six hours recorded closest to the time of drug administration. * Symptoms must be present less than 24 hours prior to baseline CT scan. * Baseline Rankin score of 0 or 1. Exclusion Criteria * Presence of infratentorial parenchymal bleeding. * Presence of a hemorrhage extending to the midbrain. * An unknown time of onset or the symptoms onset more than 24 hours prior to admission. * Pregnancy. * Inability to obtain written informed consent from subject or legal representative. * Sustained SBP \>180 mm Hg for six hours recorded closest to the time of drug administration. * Age \<18 and \>80 years. * Radiological evidence of arterio-venous malformation, aneurysm, amyloid angiopathy, Moyamoya disease, hemorrhagic conversion of an ischemic stroke, recurrent hemorrhage in the same location within the past 365 year or unstable mass as a source for the ICH. * Evidence of coagulopathy (international normalized ratio \>1.3; platelet count \<100 ,000 or platelet dysfunction P2Y-12 \>250) or known clotting disorder. * Bilateral fixed, dilated pupils indicating irreversible impaired brain stem function with GCS ≤4. * Patients with severe ICH and IVH who require an external ventricular drain (EVD) placement for cerebrospinal fluid (CSF) diversion or separate intraventricular thrombolysis. * Inability to maintain INR less than 1.3. * Use of anticoagulants prior to symptom onset and subjects requiring long-term anticoagulants (the reversal is permitted if the patient can tolerate the short-term risk of reversal). * Use of Dabigatran, Apixaban, and/or Rivaroxaban (or a similar medication from the similar medication class) prior to symptom onset. * Internal bleeding (GI, renal, respiratory etc). * Mechanical heart valve (Bioprosthetic heart valve is permitted). * Known risk for embolization, including history of left heart thrombus, mitral stenosis with atrial fibrillation, acute pericarditis, or subacute bacterial endocarditis (atrial fibrillation without mitral stenosis is permitted). * Allergy or sensitivity to TNKase. * Participation in a concurrent clinical trial. * Serious illness (advanced stage which can interfere with the outcome). * The patient is unstable and would not benefit from a surgical intervention. * GCS score of 3-4 and 15 (to ensure patient safety and study feasibility). * Historical mRS score of 2-6 (at admission). * Symptomatic tract hemorrhage or a tract hemorrhage more than 5 mm.