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Swiss trial of decompressive craniectomy versus best medical treatment of spontaneous supratentorial intracerebral
Urs Fischer1,2, Christian Fung3,4, Seraina Beyeler1
1Department of Neurology, University Hospital and University of Bern, Bern, Switzerland.
Decompressive craniectomy (DC) may not improve outcomes for spontaneous intracerebral hemorrhage (ICH). This trial compares DC plus best medical treatment (BMT) against BMT alone to assess effects on death or dependence at six months.
Area of Science:
- Neurosurgery
- Neurology
- Clinical Trials
Background:
- Decompressive craniectomy (DC) is established for malignant middle cerebral artery infarction.
- The efficacy of DC in spontaneous intracerebral hemorrhage (ICH) remains undetermined.
Purpose of the Study:
- To evaluate if DC combined with best medical treatment (BMT) reduces death or dependence at 6 months in ICH patients compared to BMT alone.
Main Methods:
- The international, multicenter, randomized SWITCH trial (NCT02258919) enrolled 300 patients (age ≤75) with deep ICH.
- Participants received either DC plus BMT or BMT alone, with DC performed within 6 hours of randomization.
- Primary outcome: composite of death or modified Rankin Scale score 5-6 at 6 months.
Main Results:
- This section is not available in the provided abstract.
Conclusions:
- The SWITCH trial aims to clarify the role of decompressive craniectomy in managing spontaneous deep intracerebral hemorrhage.
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