Does Surgery Have a Role in Intracerebral Hemorrhage Treatment?

The Surgery Trial in Intracerebral Hemorrhage (STICH) suggested that patients with a superficial hemorrhage close to the cortex could potentially benefit from surgical evacuation. To examine this issue directly, researchers have now conducted the STICH II trial. They randomized 601 patients with an intracerebral hemorrhage (ICH) within 1 cm of the cortical surface to surgical evacuation (aiming for within 12 hours of randomization) or initial conservative treatment (with surgery allowed in case of clinical deterioration). Patients were randomized within 48 hours of ICH onset, had an ICH volume of 10 mL to 100 mL, and were conscious. Patients with hemorrhage extension to the ventricular system were excluded. Median age at baseline was 65, 57…