Craniectomy for ICH The potential of DC to improve outcomes for patients with ICH has not been well studied. On the basis of the results of the first STICH trial, several authors have suggested that outcomes could potentially be improved with DC for selected patients with high ICP and mass effect related to ICH.232 234,240 Patients in these studies tended to be those in coma (GCS score <8) and those who had significant midline shift, large hematomas, or ICP that did not normalize with medical man- agement. One study of DC without hematoma evacuation matched 12 consecutive patients with supratentorial ICH to control subjects via propensity score.232 Median hematoma , and median preoperative GCS score was 8. Three patients in the study group died compared with 8 in the control group, whereas 9 patients had a study-defined good outcome.Another study on DC without hematoma evac- uation included 5 patients with recalcitrant elevated ICP.234 This small cohort fared better than matched control subjects from the authors institutional prospective ICH database. 