Local fibrinolysis and aspiration in treatment of spontaneous intracerebral hematomas (SIH) and ventricular hemorrhages (VH) have become a wide spread technique in dedicated cerebrovascular centers. Forty four patients treated in Burdenko NSI in 2007-2011 were evaluated. Local fibrinolysis for SIH were perfomed in 30 pt., for isolated VH in 14. Puroplazan, a prourokinaze based derivative (mean dose - 50 000 ME) were used in 36 cases, Actilyse (tPA) (2.0 g mean) in 8 cases. Status at discharge was improved in 66.7% of patients with SIH and 57.1% of patients with isolated VH. Mortality comprised to 10 and 28.6% correspondingly. Local hematoma aspiration and fibrinolysis is an effective minimally-invasive method of primary and secondary non-traumatic SIH and VH evacuation. Dose of fibrinolytic agent should be selected individually and depends on hematoma volume. Applied dose clinically-wise should be decreased along with reducing of hematoma size and number of injections to minimize recurrent hemorrhage risk.