Intraparenchymal Hematoma

Historically, the surgical management of intraparenchymal hemorrhage (IPH) has been heavily controversial within the literature. IPH has been described since the days of Hippocrates, and Avicenna alludes to it as well in his famous text. Not until far later were we presented with the first description of successful operative evacuation of spontaneous IPHs, for which we are indebted to Sir William MacEwen and Harvey Cushing. In subsequent years, several small monographs were published on the subject. The first major series published by McKissock and colleagues in 1961 showed no added advantage of surgical management for IPH over other treatments. However, in the pre-CT and pre-microscope era in which the research was conducted, we can wonder to what extent the results were impacted by the lack of tools that investigators today find crucial to successful neurosurgery and patient care. Subsequent trials were also inconclusive until the STICH (Surgical Trial in Traumatic Intracerebral He...

Top