{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:57:27Z","timestamp":1770116247376,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,5,26]]},"abstract":"\n BACKGROUND<\/jats:title>\n Traumatic intracerebral hemorrhage (tICH) is a common form of intracranial hemorrhage after traumatic brain injury (TBI). The role of surgical intervention in tICH remains a subject of discussion. Recent trials, such as Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH), have shown the efficacy of minimally invasive clot evacuation for non-tICH for hemorrhages with volumes of 30\u201380 mL. The generalizability of ENRICH to tICH remains unclear; however, it demonstrates the need for rigorous studies evaluating the efficacy of surgical intervention in tICH versus medical management.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Here the authors present 2 cases of tICH, both in the dominant temporal lobe, of similar volumes. One case was managed surgically and the other medically. The decision to operate on the first patient was due to interval enlargement of the hematoma. In the second patient, the decline in neurological examination was attributable to perilesional edema, and the decision was made to manage the patient medically. Both patients ultimately had good outcomes.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The management of patients with tICH remains challenging. However, having a sophisticated understanding of the biological processes underlying the patient\u2019s presentation is paramount in delivering optimal management. Larger and more granular studies are needed in order to further clarify the role of operative intervention in patients with tICH.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24591<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24591","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T20:17:48Z","timestamp":1748290668000},"source":"Crossref","is-referenced-by-count":0,"title":["Revisiting traumatic intracerebral hemorrhage in the context of ENRICH: illustrative cases"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2576-6283","authenticated-orcid":true,"given":"Erik","family":"Werheim","sequence":"first","affiliation":[{"name":"Department of Surgery, North Shore University Hospital, New Hyde Park, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"McShane","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Temple University Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Sokol","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore","family":"Hannah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Temple University Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5923-8265","authenticated-orcid":true,"given":"Robert","family":"Ziechmann","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Temple University Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Villaneuva","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Temple University Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"J Head Trauma Rehabil","first-page":"544","article-title":"Incidence of traumatic brain injury in the United States, 2003","volume":"21","author":"Rutland-Brown","year":"2006","unstructured":"Rutland-Brown WLanglois JAThomas KEXi YL.Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil. 2006;21(6):544-548."},{"issue":"12","key":"bib2","series-title":"Lancet Neurol","first-page":"987","article-title":"Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research","volume":"16","author":"Maas","year":"2017","unstructured":"Maas AIRMenon DKAdelson PDTraumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017;16(12):987-1048."},{"issue":"70","key":"bib3","series-title":"Health Technol Assess","first-page":"1","article-title":"Surgical Trial In Traumatic intraCerebral Haemorrhage (STITCH): a randomised controlled trial of early surgery compared with initial conservative treatment","volume":"19","author":"Gregson","year":"2015","unstructured":"Gregson BARowan ENFrancis RSurgical Trial In Traumatic intraCerebral Haemorrhage (STITCH): a randomised controlled trial of early surgery compared with initial conservative treatment. Health Technol Assess. 2015;19(70):1-138."},{"key":"bib4","series-title":"Front Neurol","first-page":"587587","article-title":"Predictors of mortality in traumatic intracranial hemorrhage: a national trauma data bank study","volume":"11","author":"Wu","year":"2020","unstructured":"Wu EMarthi SAsaad WF.Predictors of mortality in traumatic intracranial hemorrhage: a national trauma data bank study. Front Neurol. 2020;11:587587."},{"issue":"12","key":"bib5","series-title":"Stroke","first-page":"I115","article-title":"Mechanisms of ischemic brain damage with intracerebral hemorrhage","volume":"24","author":"Mendelow","year":"1993","unstructured":"Mendelow AD.Mechanisms of ischemic brain damage with intracerebral hemorrhage. Stroke. 1993;24(12suppl):I115-I118."},{"issue":"14","key":"bib6","series-title":"N Engl J Med","first-page":"1277","article-title":"Trial of early minimally invasive removal of intracerebral hemorrhage","volume":"390","author":"Pradilla","year":"2024","unstructured":"Pradilla GRatcliff JJHall AJTrial of early minimally invasive removal of intracerebral hemorrhage. N Engl J Med. 2024;390(14):1277-1289."},{"issue":"1","key":"bib7","series-title":"BMC Emerg Med","first-page":"17","article-title":"Predicting intracranial hemorrhage after traumatic brain injury in low and middle-income countries: a prognostic model based on a large, multi-center, international cohort","volume":"12","author":"Subaiya","year":"2012","unstructured":"Subaiya SRoberts IKomolafe EPerel P.Predicting intracranial hemorrhage after traumatic brain injury in low and middle-income countries: a prognostic model based on a large, multi-center, international cohort. BMC Emerg Med. 2012;12(1):17."},{"issue":"suppl 5","key":"bib8","series-title":"Crit Care","first-page":"S1","article-title":"The epidemiology and modern management of traumatic hemorrhage: US and international perspectives","volume":"9","author":"Kauvar","year":"2005","unstructured":"Kauvar DSWade CE.The epidemiology and modern management of traumatic hemorrhage: US and international perspectives. Crit Care. 2005;9(suppl 5):S1-S9."},{"issue":"9890","key":"bib9","series-title":"Lancet","first-page":"397","article-title":"Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial","volume":"382","author":"Mendelow","year":"2013","unstructured":"Mendelow ADGregson BARowan ENEarly surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. 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Cochrane Database Syst Rev Cochrane, ed. Published October 8, 2008;(4):CD000200."},{"issue":"3-4","key":"bib12","series-title":"Acta Neurochir","first-page":"155","article-title":"Traumatic intracerebral lesions without extracerebral haematoma in 218 patients","volume":"137","author":"Mathiesen","year":"1995","unstructured":"Mathiesen TKakarieka AEdner G.Traumatic intracerebral lesions without extracerebral haematoma in 218 patients. Acta Neurochir. 1995;137(3-4):155-163."},{"issue":"6","key":"bib13","series-title":"Br J Neurosurg","first-page":"611","article-title":"Acute traumatic intracerebral haematomas: determinants of outcome in a retrospective series of 202 cases","volume":"7","author":"Choksey","year":"1993","unstructured":"Choksey MCrockard HASandilands M.Acute traumatic intracerebral haematomas: determinants of outcome in a retrospective series of 202 cases. Br J Neurosurg. 1993;7(6):611-622."},{"issue":"2","key":"bib14","series-title":"J Neurosurg","first-page":"224","article-title":"Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases","volume":"94","author":"Boto","year":"2001","unstructured":"Boto GRLobato RDRivas JJGomez PADe La Lama ALagares A.Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases. J Neurosurg. 2001;94(2):224-232."},{"issue":"1","key":"bib15","series-title":"J Neurosurg Sci","first-page":"29","article-title":"Traumatic intracerebellar hemorrhagic contusions and hematomas","volume":"45","author":"D\u2019Avella","year":"2001","unstructured":"D\u2019Avella DCacciola FAngileri FFTraumatic intracerebellar hemorrhagic contusions and hematomas. J Neurosurg Sci. 2001;45(1):29-37."},{"issue":"11","key":"bib16","series-title":"Acta Neurochir","first-page":"3217","article-title":"Early surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study","volume":"165","author":"Van Erp","year":"2023","unstructured":"Van Erp IAMVan Essen TALingsma HFEarly surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study. Acta Neurochir. 2023;165(11):3217-3227."},{"issue":"7","key":"bib17","series-title":"Stroke","first-page":"e282","article-title":"2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association","volume":"53","author":"Greenberg","year":"2022","unstructured":"Greenberg SMZiai WCCordonnier C2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association. Stroke. 2022;53(7):e282-e361."},{"issue":"4","key":"bib18","series-title":"J Neurosurg","first-page":"518","article-title":"The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome","volume":"69","author":"Andrews","year":"1988","unstructured":"Andrews BTChiles BWOlsen WLPitts LH.The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome. J Neurosurg. 1988;69(4):518-522."},{"issue":"5","key":"bib19","series-title":"J Neurosurg","first-page":"1305","article-title":"Blossoming contusions: identifying factors contributing to the expansion of traumatic intracerebral hemorrhage","volume":"129","author":"Carnevale","year":"2018","unstructured":"Carnevale JASegar DJPowers AYBlossoming contusions: identifying factors contributing to the expansion of traumatic intracerebral hemorrhage. J Neurosurg. 2018;129(5):1305-1316."},{"issue":"1","key":"bib20","series-title":"Sci Rep","first-page":"5961","article-title":"Imaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis","volume":"14","author":"Peng","year":"2024","unstructured":"Peng JLuo TLi XImaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis. Sci Rep. 2024;14(1):5961."},{"issue":"6","key":"bib1","series-title":"J Head Trauma Rehabil","first-page":"544","article-title":"Incidence of traumatic brain injury in the United States, 2003","volume":"21","author":"Rutland-Brown","year":"2006","unstructured":"Rutland-Brown WLanglois JAThomas KEXi YL.Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil. 2006;21(6):544-548."},{"issue":"12","key":"bib2","series-title":"Lancet Neurol","first-page":"987","article-title":"Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research","volume":"16","author":"Maas","year":"2017","unstructured":"Maas AIRMenon DKAdelson PDTraumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017;16(12):987-1048."},{"issue":"70","key":"bib3","series-title":"Health Technol Assess","first-page":"1","article-title":"Surgical Trial In Traumatic intraCerebral Haemorrhage (STITCH): a randomised controlled trial of early surgery compared with initial conservative treatment","volume":"19","author":"Gregson","year":"2015","unstructured":"Gregson BARowan ENFrancis RSurgical Trial In Traumatic intraCerebral Haemorrhage (STITCH): a randomised controlled trial of early surgery compared with initial conservative treatment. Health Technol Assess. 2015;19(70):1-138."},{"key":"bib4","series-title":"Front Neurol","first-page":"587587","article-title":"Predictors of mortality in traumatic intracranial hemorrhage: a national trauma data bank study","volume":"11","author":"Wu","year":"2020","unstructured":"Wu EMarthi SAsaad WF.Predictors of mortality in traumatic intracranial hemorrhage: a national trauma data bank study. Front Neurol. 2020;11:587587."},{"issue":"12","key":"bib5","series-title":"Stroke","first-page":"I115","article-title":"Mechanisms of ischemic brain damage with intracerebral hemorrhage","volume":"24","author":"Mendelow","year":"1993","unstructured":"Mendelow AD.Mechanisms of ischemic brain damage with intracerebral hemorrhage. Stroke. 1993;24(12suppl):I115-I118."},{"issue":"14","key":"bib6","series-title":"N Engl J Med","first-page":"1277","article-title":"Trial of early minimally invasive removal of intracerebral hemorrhage","volume":"390","author":"Pradilla","year":"2024","unstructured":"Pradilla GRatcliff JJHall AJTrial of early minimally invasive removal of intracerebral hemorrhage. N Engl J Med. 2024;390(14):1277-1289."},{"issue":"1","key":"bib7","series-title":"BMC Emerg Med","first-page":"17","article-title":"Predicting intracranial hemorrhage after traumatic brain injury in low and middle-income countries: a prognostic model based on a large, multi-center, international cohort","volume":"12","author":"Subaiya","year":"2012","unstructured":"Subaiya SRoberts IKomolafe EPerel P.Predicting intracranial hemorrhage after traumatic brain injury in low and middle-income countries: a prognostic model based on a large, multi-center, international cohort. BMC Emerg Med. 2012;12(1):17."},{"issue":"suppl 5","key":"bib8","series-title":"Crit Care","first-page":"S1","article-title":"The epidemiology and modern management of traumatic hemorrhage: US and international perspectives","volume":"9","author":"Kauvar","year":"2005","unstructured":"Kauvar DSWade CE.The epidemiology and modern management of traumatic hemorrhage: US and international perspectives. Crit Care. 2005;9(suppl 5):S1-S9."},{"issue":"9890","key":"bib9","series-title":"Lancet","first-page":"397","article-title":"Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial","volume":"382","author":"Mendelow","year":"2013","unstructured":"Mendelow ADGregson BARowan ENEarly surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet. 2013;382(9890):397-408."},{"issue":"9457","key":"bib10","series-title":"Lancet","first-page":"387","article-title":"Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial","volume":"365","author":"Mendelow","year":"2005","unstructured":"Mendelow ADGregson BAFernandes HMEarly surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365(9457):387-397."},{"issue":"4","key":"bib11","series-title":"Cochrane Database Syst Rev","first-page":"CD000200","article-title":"Surgery for primary supratentorial intracerebral haemorrhage","author":"Prasad","year":"2008","unstructured":"Prasad KMendelow ADGregson BA.Surgery for primary supratentorial intracerebral haemorrhage. Cochrane Database Syst Rev Cochrane, ed. Published October 8, 2008;(4):CD000200."},{"issue":"3-4","key":"bib12","series-title":"Acta Neurochir","first-page":"155","article-title":"Traumatic intracerebral lesions without extracerebral haematoma in 218 patients","volume":"137","author":"Mathiesen","year":"1995","unstructured":"Mathiesen TKakarieka AEdner G.Traumatic intracerebral lesions without extracerebral haematoma in 218 patients. Acta Neurochir. 1995;137(3-4):155-163."},{"issue":"6","key":"bib13","series-title":"Br J Neurosurg","first-page":"611","article-title":"Acute traumatic intracerebral haematomas: determinants of outcome in a retrospective series of 202 cases","volume":"7","author":"Choksey","year":"1993","unstructured":"Choksey MCrockard HASandilands M.Acute traumatic intracerebral haematomas: determinants of outcome in a retrospective series of 202 cases. Br J Neurosurg. 1993;7(6):611-622."},{"issue":"2","key":"bib14","series-title":"J Neurosurg","first-page":"224","article-title":"Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases","volume":"94","author":"Boto","year":"2001","unstructured":"Boto GRLobato RDRivas JJGomez PADe La Lama ALagares A.Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases. J Neurosurg. 2001;94(2):224-232."},{"issue":"1","key":"bib15","series-title":"J Neurosurg Sci","first-page":"29","article-title":"Traumatic intracerebellar hemorrhagic contusions and hematomas","volume":"45","author":"D\u2019Avella","year":"2001","unstructured":"D\u2019Avella DCacciola FAngileri FFTraumatic intracerebellar hemorrhagic contusions and hematomas. J Neurosurg Sci. 2001;45(1):29-37."},{"issue":"11","key":"bib16","series-title":"Acta Neurochir","first-page":"3217","article-title":"Early surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study","volume":"165","author":"Van Erp","year":"2023","unstructured":"Van Erp IAMVan Essen TALingsma HFEarly surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study. Acta Neurochir. 2023;165(11):3217-3227."},{"issue":"7","key":"bib17","series-title":"Stroke","first-page":"e282","article-title":"2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association","volume":"53","author":"Greenberg","year":"2022","unstructured":"Greenberg SMZiai WCCordonnier C2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association. Stroke. 2022;53(7):e282-e361."},{"issue":"4","key":"bib18","series-title":"J Neurosurg","first-page":"518","article-title":"The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome","volume":"69","author":"Andrews","year":"1988","unstructured":"Andrews BTChiles BWOlsen WLPitts LH.The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome. J Neurosurg. 1988;69(4):518-522."},{"issue":"5","key":"bib19","series-title":"J Neurosurg","first-page":"1305","article-title":"Blossoming contusions: identifying factors contributing to the expansion of traumatic intracerebral hemorrhage","volume":"129","author":"Carnevale","year":"2018","unstructured":"Carnevale JASegar DJPowers AYBlossoming contusions: identifying factors contributing to the expansion of traumatic intracerebral hemorrhage. J Neurosurg. 2018;129(5):1305-1316."},{"issue":"1","key":"bib20","series-title":"Sci Rep","first-page":"5961","article-title":"Imaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis","volume":"14","author":"Peng","year":"2024","unstructured":"Peng JLuo TLi XImaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis. 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