Gustavo Pradilla, Jonathan J Ratcliff, Alex J Hall, Benjamin R Saville, Jason W Allen, Giorgio Paulon, Anna McGlothlin, Roger J Lewis, Mark Fitzgerald, Angela F Caveney, Xiao T Li, Mark Bain, Joao Gomes, Brain Jankowitz, Georgios Zenonos, Bradley J Molyneaux, Jason Davies, Adnan Siddiqui, Michael R Chicoine, Salah G Keyrouz, Jonathan A Grossberg, Mitesh V Shah, Ranjeet Singh, Bradley N Bohnstedt, Michael Frankel, David W Wright, Daniel L Barrow
BACKGROUND: Trials of surgical evacuation of supratentorial intracerebral hemorrhages have generally shown no functional benefit. Whether early minimally invasive surgical removal would result in better outcomes than medical management is not known. METHODS: In this multicenter, randomized trial involving patients with an acute intracerebral hemorrhage, we assessed surgical removal of the hematoma as compared with medical management. Patients who had a lobar or anterior basal ganglia hemorrhage with a hematoma volume of 30 to 80 ml were assigned, in a 1:1 ratio, within 24 hours after the time that they were last known to be well, to minimally invasive surgical removal of the hematoma plus guideline-based medical management (surgery group) or to guideline-based medical management alone (control group)...
April 11, 2024: New England Journal of Medicine