AHA ICH MIS Advisory 2026 — Evidence Update for Minimally Invasive Surgical Evacuation of Supratentorial Spontaneous Intracerebral Hemorrhage

Summarizes ENRICH and MIND and supports considering minimally invasive evacuation in selected patients rather than routine surgery for all ICH. The advisory highlights lobar ICH 30–80 mL, good premorbid status, NIHSS >5, GCS >5, and surgery within the first 24 hours as a practical candidate profile, while noting that MIND was neutral for 180-day mortality and functional outcome.