Haematoma (> 70 mL) before MISPT (upper), and CT scans of the same patient in consciousness (GCS score 14) 2 weeks after completed MISPT with urokinase (lower). All scans demonstrate a series size of hematoma on axial imaging.Zhou et al. BMC PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/14960617 Neurology 2011, 11:76 http://www.biomedcentral.com/1471-2377/11/Page 6 ofTable 3 Outcome 1 year after stroke of two groupsGroup Number of patients case fatality (n/ ) GOS mRS BI MISPT patients 90 17/18.9 4.3 ?0.4 2.2 ?0.3 79.5 ?11.1 CC patients 78 19/24.4 2.6 ?0.3 3.9 ?0.4 62.0 ?9.8 0.389 0.043 0.042 0.011 P valuesupport the role of ischemia in secondary perihematomal damage [3]. Therefore, effective removal of hematoma at the acute phase is the crucial principle of treatment with ICH for saving life and improving the long-term quality of life. CC by removing bone flap is the classical technique treating ICH which is characterized by good view, clearance of hematoma completely, easy haemostasia, and the entire reduction of pressure,but also 2,2,3,3-Tetrafluoropropyl N,N'-diethylcarbamimidothioate trifluoromethanesulfonate have some shortcomings such as taking long time to operate, damaging brain severely, being subject to pulling the brain in the operation, the brain tissue around the hematoma readily damaged by electrocoagulation, re-bleeding readily, producing a series of pathophysiological changes in post-operation (such as disturbance of water and electrolyte, fluctuation of blood sugar, instability of life signs and so on), which resulting in severe impairment of neurological function, multiple complications, higher invalidism rate and fatality rate. With regard to basal ganglia haemorrhages, comparing the outcome of patients treated surgically with that of patients managed conservatively, many earlier and current publications showed no benefit from conventional surgery [6,7,19-22]. Correspondly this disappointing results, only a few reports PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/3081428 have demonstrated a trend towards better outcomes in conventional surgical group [23-25]. While analysing the given data, it becomes obvious that the major problem in all these studies is the heterogeneity of the ICH patient groups 4-(Benzyloxy)-4-oxobutanoic acid with regard to their preoperative neurological status with quite different degrees of neurological impairment and not uniform consciousness levels, applying different surgical approaches and different intervals with regard to the onset of haemorrhagic stroke. Thus it is an essential issue to select appropriate patients and homogenous group for determining whether patients truly benefit from neurosurgical or not treated by stereotactic evacuation of the haematomas in the acute phase. In many recent studies the minimallyinvasive method have shown to be highly efficient with little risk of re-bleeding and better short-term outcome [26-28]. Presently, some clinicians are exploring new methods to elevate curative effect of minimally-invasive operation technique. A study by Marquardt and coworkers focused on the use of a novel multiple targetaspiration technique in 64 patients to aspirate a "sufficient proportion" of the hematoma with minimal risk for the patient. More than 80 of the hematoma volume was successfully aspirated in 73.4 of the patients with only one episode of re-bleeding [29]. Jose's study showed that ijms17122034 CT-guided thrombolysis and aspiration was safe and effective in the reduction of ICH volume. But meantime they proposed further studies were needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, disability outcome time until convalescence, and cost of care in.