How is intracerebral hemorrhage with brain herniation treated surgically?

Brain herniation requires emergency craniotomy to evacuate the hematoma and relieve the herniation; otherwise, it may compress the brainstem, leading to brainstem failure and endangering life. The surgery requires endotracheal intubation and general anesthesia. After anesthesia takes effect, a standard horseshoe-shaped or question-mark-shaped incision can be used for conventional craniotomy. Following dural opening, brain tissue is gently dissected to access the hematoma cavity, where the hematoma is evacuated and active bleeding is controlled. If cerebral swelling is severe, decompressive craniectomy should be performed simultaneously.