Neurosurgical Intervention

SWITCH

Intracerebral Hemorrhage

In adult patients (≥18 years) with spontaneous supratentorial intracerebral hemorrhage (volume 10-60 mL, GCS 5-12, pre-ICH mRS 0-1), does early surgical hematoma evacuation (within 24 hours) plus medical care, compared with initial conservative medical care alone, improve functional outcome (mRS score) at 180 days?

STICH-II

Intracerebral Hemorrhage

In adult patients with spontaneous superficial lobar intracerebral hemorrhage (10-100 mL, GCS ≥6T/7), does a policy of early surgical hematoma evacuation by craniotomy plus best medical treatment, compared with best medical treatment alone (with delayed surgery if needed), improve outcome at 6 months?

STICH

Intracerebral Hemorrhage

In adult patients with spontaneous supratentorial intracerebral hemorrhage, does a policy of early surgical hematoma evacuation plus best medical treatment, compared with best medical treatment alone (with delayed surgery if needed), improve outcome at 6 months?

MISTIE III

Intracerebral Hemorrhage

In adult patients (18-80 years) with spontaneous supratentorial intracerebral hemorrhage (volume ≥30 mL, GCS 4-14), does minimally invasive catheter evacuation followed by alteplase instillation, compared with standard medical care alone, improve functional outcome (mRS 0-3) at 365 days?

ENRICH

Intracerebral Hemorrhage

In adult patients (18-80 years) with spontaneous supratentorial intracerebral hemorrhage (lobar or basal ganglia, volume 30-80 mL, GCS 5-14), does early minimally invasive parafascicular surgery (MIPS) plus medical management, compared with medical management alone, improve functional outcome (utility-weighted mRS) at 180 days?

CLEAR III

Intracerebral Hemorrhage

In adult patients (18-75 years) with spontaneous supratentorial ICH (<30 mL) and obstructive IVH requiring an EVD, does intraventricular administration of alteplase via the EVD, compared with EVD management with or without saline irrigation, improve functional outcome at 180 days?