In 1903 Cushing1 described the surgical treatment of a case of intracerebral hemorrhage. A quarter of a century later, Bagley2 reemphasized the need for surgical treatment in instances of intracerebral hematoma; yet, the literature shows surprisingly few series of surgically treated cases until the last 10 to 15 years.
One of the main hindrances in the treatment of intracerebral hemorrhage has been the difficulty in clinical differentiation between hemorrhage, thrombosis, and embolism of the cerebrovascular tree. Frequently, the onset and presentation of intracerebral hemorrhage is insidious, and thus confusion may arise. In Kelly's3 series of cases of hemorrhage, the onset of symptoms was gradual over a period of hours or days in almost half of the patients. Guillaume4 described a case with an onset so insidious as to suggest the presence of a tumor. Beck5 and Elkington6 reported similar experiences. Bedford7 has indicated