Clinical Profile, Surgical Management, and Outcomes of Spontaneous Supratentorial Intracerebral Hemorrhage: A Prospective Study

Introduction: Spontaneous intracerebral hemorrhage (ICH) is a severe subtype of stroke caused by non-traumatic bleeding into the brain parenchyma and is associated with high morbidity and mortality. Surgical procedures such as decompressive craniectomy, decompressive craniectomy with hematoma evacuation, and endoscopic evacuation are used in selected patients to reduce mass effect and improve outcomes. The aim of this study was to evaluate the clinical profile, risk factors, surgical management, complications, and outcomes of patients with spontaneous supratentorial intracerebral hemorrhage.

Materials and Methods: This prospective observational study was conducted in the Department of Neurosurgery at Mamata Medical College and Super Specialty Hospital, Khammam, from July 2024 to June 2025. Sixty patients with spontaneous supratentorial intracerebral hemorrhage were included. All patients were resuscitated and managed in the intensive care unit. Clinical parameters, hematoma volume, preoperative Glasgow Coma Scale (GCS), postoperative complications, and functional outcomes assessed using the Modified Rankin Scale (mRS) were analyzed.

Results: Most patients were aged 61–70 years (55%) with male predominance (70%). Hypertension was the most common risk factor. Weakness or hemiplegia was the most frequent presenting symptom (38.4%). Mean hematoma volume and preoperative GCS were comparable among surgical groups (p=0.86 and p=0.773). Mortality (mRS 6) occurred in 36.7% of patients.

Conclusion: Spontaneous intracerebral hemorrhage carries high morbidity and mortality. Preoperative neurological status and hematoma characteristics significantly influence outcomes. Early diagnosis and appropriate surgical intervention may improve survival in selected patients.