Spontaneous intracerebral hemorrhage (ICH) is a major
type of hemorrhagic stroke, occurring annually in 10 to 20
persons per 100,000 populations. The most common
cause of spontaneous ICH is rupture of small penetrating
arteries after chronic insult as a result of hypertension and
more than 50% of the hemorrhage is located in the basal
ganglia. Despite major advances in early computed
tomography (CT) diagnosis, improvements in neurosurgical
critical care, and refinements in microsurgical
techniques, the mortality remains high and only 38% of
patients with spontaneous basal ganglia hemorrhage
(SBH) survive the first year. The need to develop a more
effective treatment is obvious.1-3
Decompressive craniectomy has been reported to be
beneficial in a number of conditions, including traumatic
brain injury, hemispheric stroke, and ICH associated with
aneurysmal subarachnoid hemorrhage.4-6 However, the
application of this surgical technique in patients with
SBH was much less frequent. This study was designed
to investigate whether decompressive craniectomy in
addition to hematoma evacuation could improve the
outcome of patients with SBH.