Principles and Techniques of Surgical Management of ICH

  • Josephine U. Pucci
  • Shyle H. Mehta
  • Brandon R. Christophe
  • Edward S. ConnollyJrEmail author
Part of the Stroke Revisited book series (STROREV)


Intracerebral hemorrhage (ICH) is one of the most common classes of stroke. Indications for surgery in patients with ICH are largely dependent on patient age, level of consciousness, time elapsed since ICH onset, and the site and size of hemorrhage; however, research in ICH approach, management, surgical indications, and technical management have not completely addressed some of the most common complications of this condition. In this chapter we review the efficacy of craniotomy and hematoma evacuation in various presentations following ICH. We also discuss current guidelines by which endoscopic evacuation can be considered, conclusions from a number of trials involving stereotactic catheter aspiration with fibrinolytic agents, and the use of decompressive craniectomy. We conclude that the standard of care should continue to be refined as new evidence becomes available, specifically that which is concerned with hemorrhage type and location.


Endoscopic Evacuation Decompressive Craniectomy (DC) Surgical Hematoma Evacuation American Heart Association/American Stroke Association (AHA/ASA) Perihematomal Edema (PHE) 
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Copyright information

© Springer Science+Business Media Singapore 2018

Authors and Affiliations

  • Josephine U. Pucci
    • 1
  • Shyle H. Mehta
    • 1
  • Brandon R. Christophe
    • 1
  • Edward S. ConnollyJr
    • 2
    Email author
  1. 1.Columbia University Medical Center, Columbia UniversityNew YorkUSA
  2. 2.Department of Neurological SurgeryColumbia UniversityNew YorkUSA

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