Indication and contraindication for surgery of spontaneous intracerebral hematomas. Therapy and results.

The indication for surgery in spontaneous intracerebral hematoma is given when, in spite of the administration of dexamethasone in high dosage, an improvement of the initial neurological symptoms could not be observed, or if a worsening is seen. With the help of CT the size of the hematoma could be controlled so that if in comparison to initial findings an increase in mass displacement or herniation is observed, surgery should be performed immediately. In cases of deep coma with vegetative unstable states, as well as in cases of bleeding into the basal ganglia, surgery is contraindicated.