Comparing Early Minimally Invasive Surgery to Standard Medical Care for Deep Brain Hemorrhagic Stroke Treatment in Adults Aged 18 to 70

What this Trial Is About

Researchers are investigating treatments for patients who have experienced a deep brain bleed called intracerebral hemorrhage, a type of stroke caused by a blood vessel bursting inside the brain. This trial, named REACH, compares the usual medical care to an early, minimally invasive surgical procedure for removing the blood clot. The goal is to determine if this less invasive surgery improves recovery and outcomes compared to standard treatments, which may also include surgeries to relieve brain pressure. Participants are randomly assigned to one of two groups. One group receives surgical management involving a small skull opening to evacuate the clot within 24 hours of stroke symptom onset, performed by trained neurosurgeons following detailed clinical guidelines. The other group receives medical management according to established stroke care guidelines, including intensive care admission, blood pressure control, and treatments to prevent further bleeding or complications. Both groups follow specific clinical standardization guidelines tailored to their treatment. During the study, participants will be monitored closely with evaluations such as brain imaging and clinical scales. Researchers will assess outcomes like the modified Rankin Scale score 180 days after randomization to measure recovery, hospital mortality, changes in hematoma volume, adverse events, and duration of intensive care and mechanical ventilation. The study includes follow-up assessments up to six months, with ongoing safety and recovery monitoring throughout the hospital stay and after discharge.

Rapid Evacuation and Access of Cerebral Hemorrhage Trial