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Whether DC improves outcome in spontaneous intracerebral haemorrhage (ICH) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To determine whether DC without haematoma evacuation plus best medical treatment (BMT) in people with ICH decreases the risk of death or dependence at 6\u2009months compared to BMT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and design:<\/jats:title>\n                    <jats:p>SWITCH is an international, multicentre, randomised (1:1), two-arm, open-label, assessor-blinded trial. Key inclusion criteria are age \u2a7d75\u2009years, stroke due to basal ganglia or thalamic ICH that may extend into cerebral lobes, ventricles or subarachnoid space, Glasgow coma scale of 8\u201313, NIHSS score of 10\u201330 and ICH volume of 30\u2013100\u2009mL. Randomisation must be performed &amp;lt;66\u2009h after onset and DC &amp;lt;6\u2009h after randomisation. Both groups will receive BMT. Participants randomised to the treatment group will receive DC of at least 12\u2009cm in diameter according to institutional standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample size:<\/jats:title>\n                    <jats:p>A sample of 300 participants randomised 1:1 to DC plus BMT versus BMT alone provides over 85% power at a two-sided alpha-level of 0.05 to detect a relative risk reduction of 33% using a chi-squared test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes:<\/jats:title>\n                    <jats:p>The primary outcome is the composite of death or dependence, defined as modified Rankin scale score 5\u20136 at 6\u2009months. Secondary outcomes include death, functional status, quality of life and complications at 180\u2009days and 12\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>SWITCH will inform physicians about the outcomes of DC plus BMT in people with spontaneous deep ICH, compared to BMT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT02258919<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241231047","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T02:11:46Z","timestamp":1707790306000},"page":"781-788","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Swiss trial of decompressive craniectomy versus best medical treatment of spontaneous supratentorial intracerebral haemorrhage (SWITCH): an international, multicentre, randomised-controlled, two-arm, assessor-blinded trial"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0521-4051","authenticated-orcid":false,"given":"Urs","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital and University of Bern, Bern, Switzerland 1"},{"name":"Department of Neurology, University Hospital and University of Basel, Basel, Switzerland 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital and University of Bern, Bern, Switzerland 3"},{"name":"Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany 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