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

• Published in: European stroke journal 2024-09, Vol.9 (3), p.781-788
• Main Authors: Fischer, Urs, Fung, Christian, Beyeler, Seraina, Bütikofer, Lukas, Z’Graggen, Werner, Ringel, Florian, Gralla, Jan, Schaller, Karl, Plesnila, Nikolaus, Strbian, Daniel, Arnold, Marcel, Hacke, Werner, Jüni, Peter, Mendelow, Alexander David, Stapf, Christian, Al-Shahi Salman, Rustam, Bressan, Jenny, Lerch, Stefanie, Bassetti, Claudio L. A., Mattle, Heinrich P., Raabe, Andreas, Beck, Jürgen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cerebral Hemorrhage - surgery; Decompressive Craniectomy - methods; Female; Humans; Male; Middle Aged; Study Protocols; Switzerland; Treatment Outcome
• ISSN: 2396-9873; 2396-9881; 2396-9881
• DOI: 10.1177/23969873241231047

Rationale: Decompressive craniectomy (DC) is beneficial in people with malignant middle cerebral artery infarction. Whether DC improves outcome in spontaneous intracerebral haemorrhage (ICH) is unknown. Aim: 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 months compared to BMT alone. Methods and design: SWITCH is an international, multicentre, randomised (1:1), two-arm, open-label, assessor-blinded trial. Key inclusion criteria are age ⩽75 years, stroke due to basal ganglia or thalamic ICH that may extend into cerebral lobes, ventricles or subarachnoid space, Glasgow coma scale of 8–13, NIHSS score of 10–30 and ICH volume of 30–100 mL. Randomisation must be performed