The role of surgery for most patients with spontaneous ICH remains controversial. The theoretical rationale for hematoma evacuation revolves around the concepts of preventing herniation, reducing ICP, and decreasing the pathophysiological impact of the hematoma on surrounding tissue by decreasing mass effect or the cellular toxicity of blood products.
Additionally, the current recommendations do not apply to intracranial hemorrhage caused by trauma or underlying structural lesions such as aneurysms and arteriovenous malformations, because these patients were not included in the described ICH surgery trials.
The indications for surgery in patients with ICH vary with the site of the bleed
Hemorrhagic stroke surgery
Subarachnoid hemorrhage surgery
Intracerebral hemorrhage surgery
Ischemic stroke surgery
Subdural hematoma surgery
Transient ischemic attack surgery
Coma surgery
Cerebral venous sinus thrombosis surgery