At present medical management of intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) revolves around the control of intracranial pressure (ICP). Despite best medical management mortality remains high with only 38% of patients surviving the first year. The role of minimally invasive surgery (MIS) in the treatment of ICH has gained importance over the past decade. Prolonged presence of IVH clot deep within the brain causes decreased level of consciousness. Several studies using animal models of ICH and IVH have demonstrated the efficacy of thrombolysis in reducing clot volume. There is evidence suggesting that thrombolytics used for the lysis of blood in the setting of IVH and ICH in humans may improve outcomes. The potential clinical benefits include: faster reduction of IVH and ICH clot size, faster removal of blood from the ventricular systems, reduction in the incidence of hydrocephalus, reduced time in coma, and reduced mortality.