Neurocritical Care Society Podcast HOT TOPICS: The SWITCH Trial
Jun 26, 2024
Dr. Nicholas Morris is joined by Prof. Jürgen Beck and Prof. Urs Fischer to discuss the SWITCH trial on decompressive craniectomy for deep intracerebral hemorrhage. They cover trial outcomes, analysis of secondary outcomes, serious adverse events, and advancements in intracerebral hemorrhage care.
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Lessons from Previous ICH Trials
- Previous ICH trials like STITCH and MISTI taught us about trial feasibility and inclusion criteria.
- These trials also highlighted the importance of timing for surgical intervention in ICH.
Decompressive Craniectomy for Deep ICH Before SWITCH
- Before SWITCH, only retrospective series existed on decompressive craniectomy for deep ICH, suggesting potential benefits.
- No randomized controlled trials had investigated this topic specifically.
SWITCH Inclusion Criteria
- SWITCH included severely affected deep ICH patients, with a mean hematoma volume of nearly 60ccs.
- Thalamic ICH patients were included, unlike in EnRICH, due to their worse outcomes in other trials.