The Traditional Approach

The traditional surgical treatment of an ICH consists of a formal craniotomy over the hemorrhage site by making a large opening in the skull. A corticectomy is then performed over the hemorrhage site by coagulating and opening the brain tissue to obtain access to the hematoma, which is then evacuated with suction and irrigation. Although superficial ICH can be removed with minimal destruction of normal brain tissue, the usual deep-seated, basal ganglia hemorrhages require removal of the overlying normal brain to obtain access to the deep hematomas. The larger the brain opening or corticectomy, the more the normal brain tissue is disturbed. Although this traditional approach disturbs more normal brain, it has the distinct advantage of being effective in removing the ICH.

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