Hypertensive hemorrhagic strokes in the thalamus infrequently require surgical intervention in the first 48-72 hrs if they are large and the patient is clinically deteriorating. He should be out of the danger period by now. The next steps in management are rehabilitation with physiotherapy and prevention of secondary complications like leg clots, bed sores or UTIs. His arm and leg weakness may improve over time but it is difficult to say by how much and he is unlikely to ever return to his premorbid status. Most neurological recovery happens in the first 6-9 months and plateaus by about a year.
Next Steps
He should ensure good control of his blood pressure so that he doesn’t develop another stroke in the future