What this Trial Is About

Researchers are evaluating whether minimally invasive soft channel brain hemorrhage evacuation (scMIS) is at least as effective as other neurosurgical techniques, including open craniotomy, small skull window microsurgery, and endoscopic surgery, for treating acute basal ganglia intracerebral hemorrhage (ICH) with a volume between 30 and 100 ml. The study aims to compare these methods based on the clinical outcome of death or major disability six months after treatment. This trial focuses on patients with reduced consciousness levels and blood pressure below 140 mmHg before randomization. The minimally invasive soft channel technique uses detailed knowledge of brain anatomy to find the best surgical path for catheter insertion. This procedure involves puncture, aspiration, liquefaction using intermittent infusion of medications like urokinase or alteplase, and external drainage to gradually remove the hematoma while reducing brain pressure. The comparison group includes other neurosurgical methods selected by the attending clinician based on hospital expertise and availability. Participants will be monitored for six months after randomization to assess outcomes of death or major disability using the modified Rankin Scale (mRS). The study includes clinical diagnosis confirmation by imaging, informed consent, and blood pressure control before surgery. Researchers will track the effectiveness and safety of the treatments during this period, focusing on recovery and disability levels.

Minimally Invasive Soft Channel Brain Haemorrhage Evacuation for Acute Basal Ganglia Haemorrhage-- Large Hemorrhage Evacuation (MIRACLE-L)