Role of surgery in Intracerebral Hemorrhage

What is the Role of surgery in Intracerebral Hemorrhage? 

For most Intracerebral Hemorrhage patients, the role of surgery remains uncertain.

Patients with cerebellar hemorrhage who are either deteriorating neurologically or who have brain stem compression and/or hydrocephalus from ventricular obstruction should undergo surgical removal of the hemorrhage as soon as possible.

Surgical evacuation also may be considered for those patients presenting with lobar clots >30 mL and within 1 cm of the brain surface.

What are the indications for external ventricular drain (EVD) placement and ICP monitoring? 

Patients with a GCS score of <8, those with clinical evidence of transtentorial herniation, or those with significant IVH or hydrocephalus might be considered for ICP monitoring and treatment.


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