Primary intracerebral haemorrhage (ICH) is a life threatening condition with a 60-70% risk for dependency or death at one year follow-up. Currently, acute neurointensive care and rehabilitation in a stroke unit is the only treatment that can improve survival and functional outcome. Evacuation of hematoma within 72 hours of symptom onset has not proved effective in general, but can be considered for selected patients. The question of whether the prevention of hematoma growth can improve outcome through medical haemostatic treatment needs to be proven in a randomised controlled trial.