NCT06870812 · Emory University
Rapid Evacuation and Access of Cerebral Hemorrhage Trial
(REACH)
What this study is about
The main purpose of this study is to compare patients with a deep bleed in the brain undergoing surgery to patients receiving routine medical care. The standard treatment involves admission to the Intensive Care Unit (ICU) with close monitoring and blood pressure control. It also includes other medical (non-surgical) treatments to prevent more bleeding or another stroke.
View original scientific description
The main purpose of this study is to compare patients with a deep bleed in the brain undergoing surgery to patients receiving routine medical care. The standard treatment involves admission to the Intensive Care Unit (ICU) with close monitoring and blood pressure control. It also includes other medical (non-surgical) treatments to prevent more bleeding or another stroke. Sometimes, doctors will recommend surgery to remove the blood if medical treatment alone is not successful. There is evidence that doing minimally invasive surgery early-using a small opening in the skull to remove blood-may help some patients. Researchers aim to understand whether this surgery is better than current medical treatment, which may include surgeries to relieve pressure on the brain in some cases. This study, called REACH, is comparing usual medical care to early minimally invasive surgery so doctors can know which is better for patients.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Age 18-70 years
- Pre-randomization head CT demonstrating an acute, spontaneous, anterior basal ganglia primary intracerebral hemorrhage (ICH) (the anterior basal ganglia include the caudate, putamen, and pallidum to the capsula externa and excludes the thalamus)
- ICH volume between 20 - 80 mL as calculated by an approved and standardized volumetric measurement
- Study intervention can reasonably be initiated within 24 hours after the onset of stroke symptoms. If the onset is unclear, then the onset will be considered the time that the subject was last known to be well.
- Glasgow Coma Score (GCS) 5 - 14
- Historical Modified Rankin Score 0 or 1
Exclusion criteria
- Ruptured aneurysm, arteriovenous malformation (AVM), vascular anomaly, Moyamoya disease, venous sinus thrombosis, mass or tumor, hemorrhagic conversion of an ischemic infarct, recurrence of a recent (less than 1 year) ICH, as diagnosed with radiographic imaging
- NIH Stroke Scale (NIHSS) less than or equal to 5
- Bilateral fixed dilated pupils
- Extensor motor posturing
- Intraventricular extension of the hemorrhage is visually estimated to involve greater than 50% of either of the lateral ventricles
- Primary thalamic ICH or basal ganglia hemorrhage with involvement \> 25% of thalamus
- Infratentorial intraparenchymal hemorrhage including midbrain, pontine, or cerebellar
- Use of anticoagulants that cannot be rapidly reversed (i.e., criteria is met if investigators are confident that clinically significant coagulopathy is not present after targeted correction)
- Evidence of active bleeding involving a retroperitoneal, gastrointestinal, genitourinary, or respiratory tract site
- Uncorrected coagulopathy or known clotting disorder
- Known platelet count less than 75,000 or known international normalized ratio (INR) greater than 1.4 after correction
- Patients requiring long-term anti-coagulation that needs to be initiated less than or equal to 5 days from initial ICH
- End-stage renal disease
- Patients with a mechanical heart valve
- End-stage liver disease
- History of drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements
- Positive urine or serum pregnancy test in female subjects without documented history of surgical sterilization or post-menopausal
- Known life expectancy of less than 6 months before ICH
- No reasonable expectation of recovery, do-not-resuscitate (DNR), or comfort measures only before randomization
- Participation in a concurrent interventional medical investigation or clinical trial. Patients in non-interventional/observational studies are eligible
- Inability or unwillingness of the subject or legal guardian/representative to give written informed consent
- Homelessness or inability to meet follow-up requirements
Where
- Little Rock, Arkansas
- Palo Alto, California
- Jacksonville, Florida
- Kendall, Florida
- Miami, Florida
- Atlanta, Georgia
- Chicago, Illinois
- Evanston, Illinois
- Carmel, Indiana
- Lexington, Kentucky
- Baltimore, Maryland
- Columbia, Missouri
And 7 more locations — see the full list below.
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Mar 19, 2026 · Source of record for eligibility and locations