Consider patients presenting within 48 hours of a Spontaneous Lobar Intracerebral Haemorrhage (ICH)
where there is equipoise about the relative risks / benefits of surgery.
Inclusion Criteria
Spontaneous lobar ICH on CT scan (1cm or less from cortex surface of the brain) within 48 hrs
of ictus
Best MOTOR score on GCS of 5 or 6 and best EYE score on the GCS of 2 or more.
Volume of haematoma between 10 and 100ml [using Broderick Method (axbxc)/2]
Exclusion Criteria
Clear evidence that the haemorrhage is due to an aneurysm, tumour, trauma, or angiographically
proven arteriovenous malformation (AVM).
Intraventricular haemorrhage.
Hydrocephalus
Brain stem/ cerebellar/ basal ganglia /thalamic haemorrhage or extension of the lobar haemorrhage into any of these areas.
Severe pre-existing physical or mental disability or severe co-morbidity.
If surgery cannot be performed within 12 hrs
Unreversed clotting or coagulation problems