The International Surgical Trial in Intracerebral Haemorrhage (ISTICH)

At the XIth International Brain Oedema Symposium we reported that 208 patients had been randomized in this trial from 65 centres. At the time of submission of this manuscript we have randomized 985 patients from 107 centres including Japan. The trial will continue randomising patients until the end of February 2003. The objective is to determine whether "Early Surgical Intervention" or "Initial Conservative Treatment" is the best option in patients with spontaneous supratentorial Intracerebral haemorrhage (ICH). Patients with trauma, tumours, aneurysms and angiographically proven arteriovenous malformations are excluded. Ascertainment logs from the various centres have revealed substantial variation in the rate of operation for ICH from 2% in Hungary to 90% in Lithuania. The results will remain blinded until all 6 month follow-up information has been obtained. It is anticipated that these results will therefore be known towards the end of 2003. The pooled results have shown that patients with larger Haematomas and depressed consciousness are more likely to end up with a worse outcome.