CEREBROVASCULAR DISEASE: Edited by David S. LiebeskindHaemorrhage and hemicraniectomy refining surgery for strokeBösel, Juliana; Zweckberger, Klausb; Hacke, Wernera Author Information aDepartment of Neurology bDepartment of Neurosurgery, University of Heidelberg, Heidelberg, Germany Correspondence to PD Dr. med. Julian Bösel, MD, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. Tel: +49 6221 56 39145; fax: +49 6221 56 5461; e-mail: [email protected] Current Opinion in Neurology: February 2015 - Volume 28 - Issue 1 - p 16-22 doi: 10.1097/WCO.0000000000000167 Buy Metrics Abstract Purpose of review Intracerebral haemorrhage is a devastating cerebrovascular disease with no established treatment. Its course is often complicated by secondary haematoma expansion and perihemorrhagic oedema. Decompressive hemicraniectomy is effective in the treatment of space-occupying hemispheric ischaemic stroke. The purpose of this review is to assess the role of decompressive hemicraniectomy in intracerebral haemorrhage. Recent findings After few small previous studies had suggested advantages by the combination of decompressive hemicraniectomy with haematoma removal, decompression on its own has been investigated within the last 5 years. Two case series and one case–control study in altogether 40 patients with severe spontaneous intracerebral haemorrhage have shown mortality rates ranging from 13 to 25% and favourable outcome from 40 to 65%. Summary Decompressive hemicraniectomy appears to be a feasible and relatively well tolerated individual treatment option for selected patients with spontaneous intracerebral haemorrhage. Data are insufficient to judge potential benefits in outcome. A randomized trial is justified and mandatory. Copyright © 2015 Wolters Kluwer Health, Inc. All rights resereved.