Browse by author
Lookup NU author(s): Emeritus Professor David Mendelow
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© European Stroke Organisation 2024. 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 <66 h after onset and DC <6 h after randomisation. Both groups will receive BMT. Participants randomised to the treatment group will receive DC of at least 12 cm in diameter according to institutional standards. Sample size: A sample of 300 participants randomised 1:1 to DC plus BMT versus BMT alone provides over 85% power at a two-sided alpha-level of 0.05 to detect a relative risk reduction of 33% using a chi-squared test. Outcomes: The primary outcome is the composite of death or dependence, defined as modified Rankin scale score 5–6 at 6 months. Secondary outcomes include death, functional status, quality of life and complications at 180 days and 12 months. Discussion: SWITCH will inform physicians about the outcomes of DC plus BMT in people with spontaneous deep ICH, compared to BMT alone. Trial registration: ClinicalTrials.gov Identifier: NCT02258919.
Author(s): Fischer U, Fung C, Beyeler S, Butikofer L, Z'Graggen W, Ringel F, Gralla J, Schaller K, Plesnila N, Strbian D, Arnold M, Hacke W, Juni P, Mendelow AD, Stapf C, Al-Shahi Salman R, Bressan J, Lerch S, Bassetti CLA, Mattle HP, Raabe A, Beck J
Publication type: Article
Publication status: Published
Journal: European Stroke Journal
Year: 2024
Pages: Epub ahead of print
Online publication date: 12/02/2024
Acceptance date: 18/01/2024
ISSN (print): 2396-9873
ISSN (electronic): 2396-9881
Publisher: SAGE Publications Ltd
URL: https://doi.org/10.1177/23969873241231047
DOI: 10.1177/23969873241231047
PubMed id: 38347736
Altmetrics provided by Altmetric