Neurosurgical treatments have shown great progress in recent years mainly hemorrhagic stroke.

  Neuronavegationtechnological advances allow very precise approach to injuries that required a surgical approach often without a large surgical field, considered as minimally invasive surgery.

    This may be an option for drainage of hematomas located in deep or cortico-subcortical territory. A recent MISTIE trial aims to demonstrate  as deep haematoma drainage by catheter placemant with rtPA infusion could improve the functional prognosis of them. (December 2018)

  Intraventricular hematoma also placing drainage and installation of rtPA through them improves debit and therefore the same prognosis. Studies such as CLEAR-III already completed, demonstrated that is convenient to treat with drainage+rtPA hemorrage intraventricular if volume is >20-30 cc.

In cases of arteriovenous malformations (AVM) surgery may be an option alone or in combination with endovascular embolization by neuroradiology. In these cases neurophysiological monitoring in the operating room can respect the viability of neurological paths  and language connections at the time of resection and treat AVM with higher precision.

   Sometimes radiosurgery and neurosurgery with embolization is an option for deep or difficult AVMs.