Objective: In the spontaneous intracerebral hemorrhage (SICH) there are a small number of unequivocally indicators of surgical or conservative treatment.
Development: An extensive bibliographic revision of studies of patients with spontaneous ICH admitted to Spanish Hospitals has been completed. Later on, studies related to analyses and results of mortality and functional state of surgical and conservative treatments of ICH were gathered. Using the Cochrane Collaboration Manual the methodological quality of the studies has been evaluated.
Conclusions: The chosen studies were 25 clinical series. Only two studies comparing the surgical against the conservative treatment of supratentorial ICH has been found. The intrinsic methodological quality associated to this type of studies does not allow to establish valid conclusions on the efficacy of one treatment over another. Nonetheless it has utility considering that it reveals the chosen treatment and the outcomes in the published studies. We did not found studies evaluating the efficacy of both treatments in Spain with a prospective randomised design, with an adequate size, analysing mortality, dependency and quality of life of the affected patients. Therefore, our final conclusion is that given the importance of the information that could be extracted from these studies in order to design the more efficient treatment of ICH no delay to complete them can be admitted.