Is minimally invasive evacuation a future option in the management of spontaneous supratentorial intracerebral hemorrhage?

Intracerebral hemorrhage (ICH) carries a high morbidity and mortality. Historically, it has been treated medically, with specific indications for surgical management as a last resort in critical patients. Recently published literature has shown improved functional outcomes in spontaneous ICH patients managed with minimally invasive surgery (MIS) for hematoma evacuation along with medical management. Previously, surgery was believed to be a lifesaving measure; nonetheless, the doors have been opened for future implementation of MIS as a treatment option for spontaneous ICH. This raises questions on how MIS techniques may be implemented in alternative settings, including those where ICH has the highest clinical burden including lower-and middle-income countries.