Intracerebral hemorrhage is hemorrhage occurring in the brain that can occur because of immediate trauma or structural disease process. The age-standardized mortality rate is decreasing worldwide especially in the past 20 years, but the number of cases and incidence along with number of disability-adjusted life-years and deaths keeps rising. Despite having half the incidence as ischemic stroke, intracerebral hemorrhage (traumatic or spontaneous) causes more morbidity and mortality than ischemic stroke and yet an established strategy for treatment on the lines of reperfusion therapy is a far-fetched dream. A selective review of all relevant articles covering recent treatment options and guidelines along with major emphasis of the surgical aspect and pathophysiology has been done. Complete literature review and differences between management of traumatic and spontaneous hemorrhage were sought and discussed. A pathophysiological basis of management should be followed for both these different yet similar pathologies. Understanding the etiology reveals a somewhat clearer picture regarding treatment of this highly unfortunate and devastating disease. Current interest is focused on the surgical management of the disease with the pathophysiology often been forgotten.

中文翻译：

---

自发性与创伤性颅内出血的难题

脑内出血是由于直接的创伤或结构性疾病过程而在脑中发生的出血。世界范围的年龄标准化死亡率正在下降，尤其是在过去的20年中，但是病例数和发病率以及残疾调整生命年和死亡人数一直在上升。尽管缺血性中风的发病率只有一半，但脑出血（创伤性或自发性）引起的发病率和死亡率要高于缺血性中风，而在再灌注治疗中确立治疗策略已是一个遥不可及的梦想。已经对所有相关文章进行了选择性审查，涵盖了近期的治疗选择和指南以及对手术方面和病理生理学的重点关注。寻找并讨论了完整的文献综述以及创伤性和自发性出血管理之间的差异。这些不同但相似的病理都应遵循管理的病理生理基础。对病因的了解揭示了有关这种极为不幸和毁灭性疾病的治疗的更清晰的画面。当前的兴趣集中在疾病的外科治疗上，而其病理生理学经常被遗忘。