Summary

Intracranial hemorrhage (ICH) remains the only untreatable form of stroke. In clinical trials, no benefit has been found with open surgery compared with medical therapy in reducing ICH volume in patients with stable supratentorial large hematomas. The invasiveness and risk of open surgery, particularly for deeper ICHs, and the impact on quality of life are concerns. Minimally invasive surgical (MIS) approaches (endoscopic, thrombolytic), but not open surgery, were shown to have some benefit in ICH [Prasad K et al. Cochrane Database Syst Rev 2008]. This article discusses the MISTIE technique, which is the farthest along of the MIS approaches under investigation.