In this episode, we delve into the rationale and design of the NAS-TNK trial, exploring a novel approach to acute spontaneous deep intracerebral hemorrhage management. This multicenter randomized trial investigates the integration of neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for improved patient outcomes. The study aims to determine if this advanced technique can enhance the effectiveness of thrombolysis in reducing disability and mortality compared to existing methods. This discussion is based on the abstract of the study 'Neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for the treatment of acute spontaneous deep intracerebral haemorrhage (NAS-TNK): rationale and design of a multicentre randomised trial,' published in Stroke and Vascular Neurology in 2026. Please note that this content is for educational purposes and does not constitute medical advice.